Committed to Closing the Gap

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-By Anne Lindert-Wentzell

It was Professor Michael Dodson, Australian of the Year in 2009, who said that his wish is to, “Build our understanding of what it means to protect the rights and human dignity of all Australians. Upholding human rights is about looking out for each other, taking the idea of fairness seriously. And it goes to the heart of who we are as a nation.”

A humble, yet persistent Aboriginal leader, Professor Dodson wants to secure the realisation of a dream – namely, a better future for the Indigenous of Australia – in all aspects of their lives. He is not alone. There are many others who share his dream, his vision; others, who see the need for reform, acknowledgment and education in all matters related to Indigenous issues. There can be no vision without focus.

Professor Neil Thomson is another advocate for change, particularly in Indigenous health. As Professor of Indigenous Australian Health at Perth’s Edith Cowan University, Professor Thomson is Founder and Director of the Australian Indigenous HealthInfoNet.

From an initial team of two in 1997, HealthInfoNet has grown to a team of 27. HealthInfoNet is an innovative, internet, evidence based medium for ‘closing the gap’ in health between the Indigenous and non-Indigenous peoples in Australia. Core funding is provided by the Australian Department of Health and Ageing and Torres Strait Islander Health.

Who are Australia’s Indigenous? Neil elaborates that, “There is more than one unique Indigenous group… there are Aboriginal people and the Torres Strait Islander people. They are deemed to be two distinct groups… the Torres Strait Islander people, which is a relatively smaller number, want to have their own uniqueness, therefore, Aboriginal and Torres Strait Islander is the correct term to be using… generally, there is a fair degree of acceptance of the combined term – Indigenous.”

Knowledge and translational research is the foundation of HealthInfoNet’s main objective –transitioning information about Indigenous health into policy and practice in the form of a database to inform practice and policy for those whose aim is to see improved Indigenous health and wellbeing. “The principle of translational research and other information into any practice or policy means that people have to pick out the core research and other information that’s relevant, and try to make sense of it… that is what we do at a population level,” explains Neil.

The website offers published and research-specific material to aid in knowledge and is freely available to all users working or studying in the Indigenous health area. The evidence-based research and evidence-informed decision making enables practitioners and policy makers access to the best available research – a framework of knowledge utilisation and translation. Neil explains that, “We look for information… we have an active process in identifying all the sources we would use. Certainly some of the information would be easy to find. We try to identify all that we can… our main focus is on the current information. One of the difficulties of looking at Aboriginal status is that the methods of collection have changed slightly over time.”

Collectively, the statistics combined with other relevant research presents “a global picture of what’s happening,” adds Neil. “Both practice and policy can be informed by a holistic view rather than an ad hoc point of view.” Neil elaborates that translational research provides additional benefits to health care teams in the form of professional development. “If people are going to function properly in their health areas, they need to maintain their skills and knowledge. The type of work we are doing provides an opportunity to improve their accessed list of knowledge to deliver the best service.” Both Facebook and Twitter are utilised as well to inform about the latest news and developments in Indigenous health.

The Indigenous represent 2.6 per cent of all Australians. And it’s no secret that they suffer a greater burden of ill health and have shorter life expectancies compared to the non-Indigenous. They also experience greater difficulty in accessing health services, have higher levels of emotional distress and are often socially and economically disadvantaged. There are numerous factors contributing to this reality, but essentially, says Neil, “Basically, the way that we interpret what causes health problems fluctuates a bit… historically, people recognised that health was determined by a variety of things… when the medical profession became dominant in the mid 20th century onward, they imposed their interpretation of what caused health problems.” Determining the success of health care programs remains a multifaceted area of study. “It’s very complex to work out how health improvements are taking place… people still argue largely about what have been the predominant cause of health improvements,” says Neil.

Since 2007, Australia’s Close the Gap Campaign is striving to achieve health and life expectation equality for the Indigenous population by 2030. Comprised of Indigenous and non-Indigenous health bodies, NGO’s and human rights organisations, Close the Gap Campaign targets are supported by a partnership with the Indigenous, their representatives and Australian governments. The standard of the Campaign, the Statement of Intent, was signed in 2008 at the Campaign’s National Indigenous Health Equality Summit in Canberra.

Just recently, the Victorian Government has signed the Statement of Intent, reaffirming its commitment to Indigenous Health along with 20 Victorian hospitals CEOs at an Aboriginal Health Conference in Melbourne. This recommitment secures a working relationship to improve health outcomes for this group.

As a result of the Closing the Gap initiative, the investment in Indigenous primary health care has increased. 2008-2009 estimates indicated that the total health expenditure for the Indigenous group was approximately $3,700 million. The average health expenditure per Indigenous person was $6,787 compared to the non-Indigenous amount of $4,876.

According to the Australian Medical Association’s latest health audit report, funding must be sustained after the government implemented National Partnership Agreement on Indigenous Health Outcomes expires in 2013, in order for the Gap to be properly closed. It’s crucial that decision makers and policy setters such as CEOs remain involved. There is also a need for Indigenous communities to strengthen and develop effective solutions to local health problems.

Says Neil, “The emergence of Aboriginal health care has been initiated largely by Indigenous groups supported by some caring non-Indigenous groups… the growth of Aboriginal community controlled health services, particularly the larger and stronger ones, tend to be based in major cities or major rural areas. The ones delivering services in remote areas tend to be smaller, still delivering a great service, but probably not so active politically and in their movement there.”

The goal of HealthInfoNet has been and continues to be, “To close the gap between Indigenous and non-Indigenous peoples in terms of health care… the complexity of the determinants of health care is going to come from a variety of factors before you see the health outcome achievements. It is going to come from education, employment, self respect… all these will add up to being transmitted indirectly to improvements in health,” says Neil, adding that, “There is no doubt that the type of work we are doing needs a lot more support. Part of what we do is the necessary infrastructure to actually inform decision making and practice in Aboriginal and Torres Island health.”

Along with HealthInfoNet, Neil is also founder of the Australian Indigenous HealthBulletin, which celebrated its 30th year this year. As HealthBulletin’s editor, Neil realises that pertinent information is not readily accessible to those involved in Indigenous health. Much of the relevant information is not published, and if it is, it is randomly placed amongst many journals and other sources. The HealthBulletin was created out of a need to provide a more appropriate, organised means of making relevant information accessible to those that need it.

Concluding, Neil affirms that the work done at HealthInfoNet is, “Not done in isolation. We have a national advisory board… we work with reference groups in a number of areas and we have a network of over 140 HealthInfoNet experts around the county who guide us in what we’re doing.”

Making Sense of Management

Management is the art, or science, of getting things done through people. Sounds fairly straightforward – except for the fact that people are not robots waiting to do our bidding. People have their own minds, motivations, and goals. So how do managers keep operations – and the people behind them – running as planned?

January 16, 2019, 3:59 PM AEDT