Summary community consultation

from Health Needs Assessment 2022-2025

by murrumbidgeephn

Summary risk factors

Reduce mortality, premature deaths, avoidable deaths and morbidity due to cancer

Reduce prevalence of asthma

Reduce premature mortality due to respiratory system disease

Reduce premature mortality due to chronic obstructive pulmonary disease

Reduce premature mortality, avoidable deaths and morbidity due to road traffic injuries or transport accidents

Reduce mortality due to digestive disease, specifically liver disease

Reduce deaths due to hypertensive disease Higher mortality rate due to neoplasms males (rank 25/31, variance to Aust -13%) and females (rank 25/31, variance to Aust -12%) Higher rate of premature deaths due to cancer (rank 28/31, variance to Aust -16%); breast cancer (rank 29/31, variance to Aust -16%) Higher rate of avoidable deaths due to cancer (rank 31/31, variance to Aust -24%); breast (rank 29/31, variance to Aust -17%) 5th leading cause of death – lung cancer 6th leading cause of death – colorectal cancer 9th leading cause of death – prostate cancer 10th leading cause of cancer – unknown or ill-defined primary site 13th leading cause of death - pancreatic cancer 14th leading cause of death – breast cancer Higher rate of potential years of life lost for all cancers (rank 25/31, variance to Aust -16%); breast cancer (rank 28/31, variance to Aust -12%) Higher proportion as a long term health condition –asthma (rank 29/31, variance to Aust -24%)

Higher rate of premature mortality due to respiratory system disease (rank 27/31, variance to Aust -37%) AIHW 2018; Table 166 Mortality due to cancer

PHIDU 2014; Table 167 Premature mortality due to cancer

PHIDU 2014; Table 169 Avoidable deaths due to cancer

AIHW 2015-19; Table 104 20 top leading causes of death in Australia and MPHN

PHIDU 2014; Table 171 potential years of life lost

AIHW 2016; Table 173 Long term respiratory disease

PHIDU 2014; Table 176 Premature mortality due to respiratory system disease

4th leading cause of death – chronic obstructive pulmonary disease AIHW 2015-19; Table 104 20 top leading causes of death in Australia and MPHN

Higher rate premature mortality due to road traffic injuries (rank 26/31, variance to Aust -98%) Higher potential years of life lost – road traffic injuries (rank 28/31, variance to Aust -122%) Higher rate of avoidable deaths from transport accidents (rank 27/31, variance to Aust -103%) PHIDU 2014; Table 179 Premature mortality due to road traffic injuries PHIDU 2014; Table 181 Potential years of life lost – road traffic injuries PHIDU 2014; Table 180 avoidable deaths from transport accidents

Higher rate of mortality due to digestive disease AIHW 2018 19th leading cause of death – liver disease AIHW 2015-19; Table 104 20 top leading causes of death in Australia and MPHN

11th leading cause of death – hypertensive disease AIHW 2015-19; Table 104 20 top leading causes of death in Australia and MPHN

Generally, in the Aboriginal and Torres Strait Islander survey, the 39 respondents reported community spirit and friendly people were the best things about living in their towns. Respondents were generally proud, thought their communities coped with challenges, had access to non-health related services and sporting facilities, could get involved and that their communities were safe. These results were similarly reported in the non-Aboriginal community survey of 751 respondents who in addition to community spirit and friendly people thought the best things were the lifestyle and natural environment of their towns. Similarly, slightly higher proportions of people reported pride, community resilience, community involvement, access to no health related facilities and safety in the community survey.

Differences between the Aboriginal and Torres Strait Islander cohort and the non-Aboriginal cohort were reported for being treated with respect, this was as low as a third in the Aboriginal and Torres Strait Islander cohort (33%) and as high as 60% in the non-Aboriginal cohort. For whether a person thought that racism was a problem in their community in the Aboriginal and Torres Strait Islander survey 67% reported this compared with the 38% in the non-Aboriginal survey. The cost of living was also different between both cohorts with 56% in the Aboriginal and Torres Strait Islander cohort reporting that living costs were affordable compared with 40% in the non-Aboriginal cohort.

People’s experience in their community was high in both cohorts for feeling part of the community, participating in community activities, getting help from family friends or neighbours, accessing community support groups and getting involved in local decision making processes. In the non-Aboriginal cohort less than a third (28.5%) have experienced racism in the Aboriginal and Torres Strait Islander cohort this was nearly three times that (79%).

Self-report of health and overall life satisfaction was different between the cohorts with far greater ratings of health (75% non-Aboriginal, 54% Aboriginal and Torres Strait Islander) and overall life satisfaction (82% nonAboriginal, 62% Aboriginal and Torres Strait Islander).

In the non-Aboriginal cohort people reported an average of 1.5 health conditions, in the Aboriginal and Torres Strait Islander cohort that quadrupled to 4.5 health conditions. Both cohorts reported weight and nutrition issues (36.9% non-Aboriginal, 48.7% Aboriginal and Torres Strait Islander), mental health issues (28.1% nonAboriginal, 46.2% Aboriginal and Torres Strait Islander), arthritis (34.1% non-Aboriginal, 30.8% Aboriginal and Torres Strait Islander), high blood pressure (26% non-Aboriginal, 23.1% Aboriginal and Torres Strait Islander), chronic pain (22.2% non-Aboriginal, 28.2% Aboriginal and Torres Strait Islander) more frequently than other conditions. In the Aboriginal and Torres Strait Islander cohort they also reported lung disease (25.6%) as a significant health issue.

The five top issues that people thought affected their whole community were similar between the two cohorts in terms of order but different in magnitude. The top five issues in order included mental health issues; drug and alcohol misuse; housing affordability; ageing issues; poor access to health care; family violence; and cancer. Other significant issues included cost of living; social isolation; child abuse/neglect; family violence; diabetes; suicide; and transport issues.

In the Aboriginal and Torres Strait Islander cohort and the non-Aboriginal cohort difficulty accessing services was higher than 50% with the exception of childcare and education and training. Access difficulty for both cohorts was noted for GPs, specialist doctors, allied health, alcohol and other drug services and mental health services.

Asked what could happen to improve health and wellbeing, most Aboriginal and Torres Strait Islander people responses indicated a lack of access to quality health services, including accountability of those health services. Suggestions to improve health and wellbeing included hubs to meet and yarn up, mentoring programs, early intervention, adequate housing, respect and understanding, youth activities, support groups and affordable services. Access to mental health services featured prominently in the types of services to make available. Ensuring cultural safety was also suggested. Access to quality workforce, access to allied health, access to specialists, mental health services, AOD services, health literacy and holistic services were also consistently noted.

In the non-Aboriginal cohort the response followed the same themes, access to specialists, mental health and AOD services, GPs, allied health, aged care, maternal, child and youth services and hospital services were all raised as issues. Access and awareness of where and how to access services was a major recurring theme in both the community survey and the mini feedback received.

Eighteen themes were identified from the Aboriginal and Torres Strait Islander and non-Aboriginal community consultations through survey and feedback. Table 9 describes the priority areas and the population groups affected relating to community feedback. Table 10 provides a description of evidence where there is difference between cohorts and evidence of need expressed by communities.

Table 9: Priority areas for action for population groups from community consultations

Increase respect and reduce racism and discrimination Aboriginal and Torres Strait Islander people 

Respond to issues relating to family violence  Respond to issues relating to social isolation  Respond to issues relating to child abuse/neglect Respond to issues relating to housing affordability, transport and cost of living Improve health literacy including education relating to access and awareness of services available Respond to issues relating to poor access to healthcare including GPs, specialists and allied health Respond to issues relating to weight and nutrition Respond to issues relating to diabetes

Respond to issues relating to mental health including access to services Respond to issues relating to arthritis Maternal, Child and Youth Older persons Population

Respond to issues relating to high blood pressure Respond to issues relating to chronic pain

Respond to issues relating to lung disease

Respond to issues relating to cancer

Respond to issues relating to suicide

Respond to issues relating to drug and alcohol misuse including access to services  

Respond to issues relating to ageing issues   

Table 10: Summary of evidence for priority areas health conditions

Outcomes of the health needs analysis

Identified Need Key Issue Increase respect and reduce racism and discrimination Treated with respect (disagree, 37% non-Aboriginal, 64% Aboriginal and Torres Strait Islander) Racism is a problem in our community (agree,39% nonAboriginal, 67% Aboriginal and Torres Strait Islander) Experienced racism (agree, 28% non-Aboriginal, 79% Aboriginal and Torres Strait Islander)

Respond to issues relating to family violence 26.9% non-Aboriginal, 51.3% Aboriginal and Torres Strait Islander

Respond to issues relating to social isolation 24.6% non-Aboriginal, 38.5% Aboriginal and Torres Strait Islander

Respond to issues relating to child abuse/neglect 33.3% Aboriginal and Torres Strait Islander

Respond to issues relating to housing affordability, transport and cost of living Housing affordability 36% non-Aboriginal, 59% Aboriginal and Torres Strait Islander Cost of living 30.5% non-Aboriginal, 59% Aboriginal and Torres Strait Islander Transport 27.7% non-Aboriginal, 30.8% Aboriginal and Torres Strait Islander

Improve health literacy including education relating to access and awareness of services available

Respond to issues relating to poor access Poor access to healthcare 43.6% non-Aboriginal, 59% Aboriginal and Torres Strait Islander Description of Evidence MPHN 2021: Table 189: Aboriginal and Torres Strait Islander about your community…

MPHN 2021: Table 190: Aboriginal and Torres Strait Islander about your experience…

MPHN 2021: Table 202: About your community…

MPHN 2021: Table 203: About your experience…

MPHN 2021: Table 193: Aboriginal and Torres Strait Islander five most serious health and wellbeing concerns for your community as a whole

MPHN 2021: Table 206: Five most serious health and wellbeing concerns for your community as a whole

MPHN 2021: Table 193 Aboriginal and Torres Strait Islander five most serious health and wellbeing concerns for your community as a whole

MPHN 2021: Table 206: Five most serious health and wellbeing concerns for your community as a whole

MPHN 2021: Table 193: Aboriginal and Torres Strait Islander five most serious health and wellbeing concerns for your community as a whole

MPHN 2021: Table 206: Five most serious health and wellbeing concerns for your community as a whole

Aboriginal community and mini feedback survey qualitative responses Page 157

Community and mini feedback survey qualitative responses Page 166

MPHN 2021: Table 193: Aboriginal and Torres Strait Islander five most serious

to healthcare including GPs, specialists and allied health

Respond to issues relating to weight and nutrition Difficulty accessing GP 51% non-Aboriginal, 77% Aboriginal and Torres Strait Islander Difficulty accessing specialist 77% non-Aboriginal, 92% Aboriginal and Torres Strait Islander Difficulty accessing allied health 73% non-Aboriginal, 82% Aboriginal and Torres Strait Islander 36.9% non-Aboriginal, 48.7% Aboriginal and Torres Strait Islander

Respond to issues relating to diabetes 30.8% Aboriginal and Torres Strait Islander

Respond to issues relating to mental health including access to services 28.1% non-Aboriginal, 46.2% Aboriginal and Torres Strait Islander

57.5% non-Aboriginal, 82.1% Aboriginal and Torres Strait Islander

73% non-Aboriginal, 90% Aboriginal and Torres Strait Islander

Respond to issues relating to arthritis 34.1% non-Aboriginal, 30.8% Aboriginal and Torres Strait Islander

Respond to issues relating to high blood pressure 26% non-Aboriginal, 23.1% Aboriginal and Torres Strait Islander

Respond to issues relating to chronic pain 22.2% non-Aboriginal, 28.2% Aboriginal and Torres Strait Islander

Respond to issues relating to lung disease

Respond to issues relating to cancer 25.6% Aboriginal and Torres Strait Islander

32.4% non-Aboriginal health and wellbeing concerns for your community as a whole

MPHN 2021: Table 206: Five most serious health and wellbeing concerns for your community as a whole

MPHN 2021: Table 194: Aboriginal and Torres Strait Islander service access

MPHN 2021: Table 207: Service access