New reports provide important insights for those concerned with the prevention of illness and suffering, and are timely as we head towards a federal budget and election.
Summarised below, they cover topics ranging from anti-racism, to addressing poverty, improving preventative healthcare for Aboriginal and Torres Strait Islander people, and the many benefits of home-grown produce.
We also detail a new collaboration that is pressuring governments to step up investment in prevention.
Road map for addressing racism
Australian governments should identify racism as an urgent national health priority with significant impacts on the physical and mental wellbeing of First Nations and other affected communities.
They should also mandate comprehensive cultural safety and anti-racism education throughout all health curricula, and within all workforce practice standards and regulation requirements.
These are among 63 recommendations from the National Anti-Racism Framework, launched this week by the Australian Human Rights Commission, which provides a roadmap for governments, business and community organisations to address all forms of racism.
In developing the framework, the Commission said it had established that “urgent action is needed to address the systemic and structural racism that is deeply embedded throughout Australia”.
“Despite the pervasiveness of racism, there is an absence of a unified, robust, and comprehensive plan to guide action by Australian governments, businesses, and civil society.”
The Australian Government establish a National Anti-Racism Taskforce, to be co-chaired by the Race Discrimination Commissioner and a Secretary (representing the Australian Government’s Secretaries Board), with senior government membership from across federal, state and territory jurisdictions, and relevant peak organisations, to oversee and advise on the implementation of the National Anti-Racism Framework.
It also stresses the importance of truth-telling and self-determination for First Nations peoples.
Other recommendations include:
- The Australian Government comprehensively incorporate the United Nations Declaration on the Rights of Indigenous Peoples into domestic law.
- Australian governments incorporate cultural safety codes of practice into workplace health and safety legislation.
- Australian governments, in partnership with the Coalition of Peaks, develop a nationally recognised definition of First Nations cultural safety, with minimum standards, for application across sectors, including health.
- The Australian Government adopt and fund a National Anti-Racism Data Plan, to outline a national approach to collecting, using, and managing data on experiences, reports, and impacts of racism across states and territories and local jurisdictions.
- The Australian Government and relevant non-government organisations commit to collecting data about experiences of racism, including systemic and structural racism, in ongoing national surveys.
- Medium and large employers in all sectors develop internal workplace anti-racism strategies.
- Australian governments increase funding for research to address gaps in existing research and contribute to the evidence base on the efficacy of anti-racism initiatives and interventions in education settings, including systemic reforms.
- Australian governments increase funding to community-controlled agencies that support First Nations children and families in order to reduce child protection interventions.
- The Australian Government strengthen regulation of media organisations on reporting related to First Nations and other negatively racialised communities, informed by the Australian Human Rights Commission’s forthcoming research on media regulation and standards.
- The Australian Government establish a research fund to better understand experiences of racism and effective anti- racism strategies to create a more accessible, diverse, equitable, and representative media and arts landscape in Australia.
While the Framework’ design and implementation are best coordinated by the Australian Government, the Commission says business, community, and civil society organisations can independently implement anti-racism solutions appropriate within their sectors and spheres of influence.
“The Framework contains several recommendations that organisations can implement independently of government.”
Race Discrimination Commissioner Giridharan Sivaraman said the new framework “provides the most detailed and wide-ranging approach in our nation’s history to eliminating racism from our civic institutions and for making Australia a more just, equitable and inclusive society where everyone can feel they belong and can thrive”.
“A society in which everyone can thrive means a better society for all of us, including those not affected by racism,” he said.
Australia’s Aboriginal and Torres Strait Islander Social Justice Commissioner Katie Kiss described the framework as “an important and unprecedented milestone in our country’s history”.
“That we are at the point where we can name racism for what it is, locate it within the structures that surround us and develop a plan to transform those structures is worth celebrating, committing to, and fully realising,” she said.
National Anti-Racism Framework resources
- Read the summary or the full National Anti-Racism Framework.
- The following reports have contributed to the development of the National Anti-Racism Framework:
- Dismantling systemic racism – perspectives from First Nations peoples
- An Anti-Racism Framework: The Perspectives of Multicultural Australia
- Anti-Asian Racism Resources
- Mapping government anti-racism programs and policies
- Race Reporting Handbook – a guide for media professionals on anti-racism
- National Anti-Racism Framework Scoping Report
The Australian Human Rights Commission’s separate research projects about legal reform on online racism and hate, racism in health, and anti-racism data are each expected to be published in early 2025.
Prevention in primary healthcare
Recommendations for addressing racism and climate health concerns are among topics covered in the latest edition of the National guide to preventive healthcare for Aboriginal and Torres Strait Islander people.
This fourth edition of the guide, published by the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Royal Australian College of General Practitioners (RACGP), reflects a commitment to increase Aboriginal and Torres Strait Islander authorship.
It has 15 Aboriginal and/or Torres Strait Islander authors in 21 of the 45 topics. Many topics are co-authored, often with combinations of clinicians and researchers. Among the clinicians, there is a range of disciplines including GPs, nurses, Aboriginal health practitioner, exercise physiologist, psychologist and some non-GP medical specialists.
In recognition of the holistic and team-based nature of primary care, this edition is designed to be a resource for the entire care team, including Aboriginal and Torres Strait Islander health workers, health practitioners and nurses.
On racism, the guide encourages practitioners to integrate reflexive practice into continuing professional development, including reflecting on how your own cultural perspective, privilege, power, assumptions and biases may impact on the delivery of healthcare for Aboriginal and Torres Strait Islander patients, their families and communities.
This chapter, written by Dr Bronwyn Wilkes, Emily Colonna, Associate Professor Katherine Thurber and Professor Raymond Lovett, also recommends:
- Building a practice’s capacity to attract, recruit, retain, support and develop Aboriginal and Torres Strait Islander staff.
- Building partnerships with Aboriginal and Torres Strait Islander organisations to provide better support, including referrals to programs, and improve culturally safe care.
- Communicate clearly in trauma-informed ways, tailored to the person: use plain English and translators when needed and explain the processes and actions involved in an assessment or treatment, including asking permission before doing anything involving touch.
- Where possible, allow additional time for providing healthcare to people who have experienced trauma (eg Stolen Generations survivors).
- Validate people’s feelings when they share their stories of racism or other trauma. Provide perspective, for example by explaining it is not their fault. Provide tools for empowering and healing. Avoid making dismissive statements about people’s trauma.
- Support self-determination by engaging meaningfully in shared decision making.
A chapter on the health impacts of climate change, written by Associate Professor Veronica Matthews and Professor Sarah Larkins, notes that GPs and other primary healthcare professionals have a key role to play in preventing adverse health outcomes in their patients from climate change and extreme weather events and advocating for patient access to appropriate resources to reduce health risk.
Best practice clinical care that holistically promotes physical, social and emotional wellbeing (SEWB), and includes activities that facilitate connection to and caring for Country, will support the health of patients, communities and the planet for future generations.
Other recommendations include:
- Identify vulnerable patients with respect to climatic conditions and air pollution and add seasonal recalls and reminders for primary and secondary prevention. This register of at-risk patients could also be used to develop protocols for offering video or telephone visits, or home visits, rather than in-person visits, to avoid exposure on days with a high heat index or poor air quality.
- Incorporate questions (and appropriate advocacy, educational and healthcare delivery responses) about housing, energy security and knowledge of personal climate risk reduction strategies into annual health checks and chronic disease management plans for relevant patients.
- GPs and other key practice staff should participate in regional emergency and disaster planning, including planning around surge workforce and surveillance and response to communicable disease outbreaks.
- Advocate for Aboriginal and Torres Strait Islander community inclusion in climate action and disaster risk reduction planning.
- Provide training for all clinical and non-clinical staff in appropriate responses to climatic extremes, environmental change and health.
- Engage in strong advocacy where necessary to improve environmental, social and cultural determinants of health.
- GPs and other primary healthcare professionals can also model behaviours that reduce carbon emissions and urge their profession and the broader health and political systems to adopt environmentally sustainable policies and practices. This could including walking or cycling rather than driving and eating less or no meat.
- Promote green spaces in urban areas for community access to parks, shaded spaces and exercise areas.
NACCHO instigated the first edition of the guide in 2005 and has collaborated with the RACGP across all editions.
The deprivation of poverty
The hardship inflicted on people who are on low incomes, especially those reliant on payments such as JobSeeker Payment, Parenting Payment, Disability Support Pension and Youth Allowance, is revealed in a new report.
Called ‘Material deprivation in Australia: the essentials of life’, the report also shows that unemployed households, sole parent families, households renting social housing and First Nations people also faced a much higher risk of multiple deprivation.
The report identifies the type of essential services and products that are not available to people on low incomes. People on income support payments most often lack protections against future risks including at least $500 in emergency savings, home contents insurance or comprehensive car insurance, and items for children, including new school clothes, as well as dental treatment.
The lack of these essentials deprives them and their children of “core elements of a decent and socially acceptable standard of living in Australia”, says the report, which is published by the Australian Council of Social Service, in partnership with UNSW Sydney.
This report uses data from three waves of the Household Income and Labour Dynamics in Australia (HILDA) survey to analyse changes in deprivation over the three time periods spanning eight years. It is the 24th report published by the Partnership.
Among people receiving a JobSeeker Payment, 44 percent are living below the poverty line, as are 36 percent of those receiving a Parenting Payment or a Disability Support Pension.
Among people receiving a Youth Allowance, 26 percent are living below the poverty line.
“There is little doubt that those receiving JobSeeker Payment, Parenting Payment, Disability Support Pension or Youth Allowance face an acute risk of severe economic and social disadvantage,” says the report.
Commenting on the report, ACOSS CEO Dr Cassandra Goldie said that people receiving income support are experiencing multiple material deprivation at rates that far exceed the general population.
“This tells us that JobSeeker, Youth Allowance and related payments are so woefully low that people can’t afford the basic essentials of life,” she said.
“In its upcoming Budget, the Federal Government must raise income support payments to liveable levels, fix employment services, boost social housing and enact a jobs, services and training plan to reduce long-term unemployment. These policies will go a long way to reducing poverty and material deprivation across Australia.”
Jesuit Social Services CEO Julie Edwards said: “Through our programs supporting people and communities on the margins, we know that people receiving income support are often having to make extraordinarily difficult decisions about choosing whether to pay for medication or their children’s school supplies. This report puts in stark focus the material deprivations that people are experiencing every single day.
“We have long known that the income support system is inadequate and does not allow recipients to lead dignified lives – let alone during a cost-of-living crisis like we are currently in. We call on our political leaders to lift income support to allow recipients to live above the poverty line and increase their ability to afford access to essentials.”
Mission Australia CEO, Sharon Callister said: “This report confirms what our frontline workers see daily: despite Australia’s wealth, too many people on the lowest incomes who rely on income support, or rent social housing, are struggling to afford life’s essentials and are living in deprivation.”
JobSeeker is currently $56 a day. ACOSS wants it to match the pension rate of $82 per day.
Calls to invest in prevention
Consumer health groups united this week in calling on the 48th Australian Parliament – which will follow next year’s federal election – to commit to investing five percent of the health budget on preventative health.
Members of the Coalition for Preventative Health Funding include: Emerge Australia, Chronic Pain Australia, Arthritis Australia, Hepatitis Australia, Health Consumers Council WA, Health Consumers QLD, Consumers Health Forum of Australia, Dementia Australia, Inherited Cancers Australia, Immune Deficiencies Foundation Australia, Health Equity Matters, Macular Disease Foundation Australia, Crohn’s and Colitis Australia, Genetic Alliance Australia, Health Consumers Tasmania, Breast Cancer Network Australia, Health Care Consumers’ Association of the ACT and Cancer Voices NSW.
Consumers Health Forum of Australia CEO Dr Elizabeth Deveny said preventive health approaches not only enhance the overall health of communities but also reduce non-urgent medical visits.
“We know Australians want to stay well and avoid getting sick in the first place. If the Government adequately funded preventive measures, we could ensure the right tools and resources are activated in our communities at the right time and in the right way,” Deveny said in a statement.
“Communities should also have a say in where and how these preventative investments are spent. COVID-19 taught us that a one-size-fits-all approach to health promotion and prevention simply doesn’t work.”
As highlighted by the reports summarised above, however, it’s clear that much of the work of prevention happens outside of the health portfolio and budget.
Perhaps we should be pitching for five percent of all Government spending to be directed towards the work of prevention, in order to address issues such as poverty, housing and food insecurity, racism and pollution?
Dig this…
Meanwhile, to end up an upbeat note, watch this launch of the Grow Your Own report, produced by the Australia Institute and Grow It Local, a community organisation that facilitates and educates Australians to grow, share and eat locally grown foods.
Read the report here. It might be of use for those interested in social prescribing, for example.
See Croakey’s archive of articles on prevention
