Some reading you mustn’t miss

While the front pages and buckets of airtime are being devoured by the question of whether the wealthy should have to pay more for their private health insurance, there are other, far more important things that you could be reading about.

The 18 May edition of the Medical Journal of Australia is devoted to Indigenous health,  and is well worth a read.

One article stands out in particular, both because of the vibrancy with which it is written and the poignancy of its subject – the lack of access to appropriate health services for Indigenous people in jails.

Beverley Spiers is an Aboriginal health worker at the Cessnock Correctional Centre and she writes with a zing and a candour that suggest she is passionate about her work and doesn’t mind ruffling feathers if that will help her patients.

She says Aboriginal prisoners don’t normally access the mainstream Justice Health centres in the jails because Aboriginal staff from many external Aboriginal Medical Services can’t regularly visit the the centres any more due to a lack of staff and funding.

“Despite the Royal Commission into Aboriginal Deaths in Custody 20 years ago, which recommended that culturally appropriate medical care be provided to offenders, with access to Aboriginal Health Workers wherever possible, and despite what you read in annual reports since then, Justince Health 10 years ago adopted an unofficial policy of mainstreamed take-it-or-leave-it medical service to Aboriginal offenders,” she writes.

“It is now slowly moving away from this stance by employing its own Aboriginal Health Workers as part of the health centre staffing profile, beginning with one of the newer facilities at Wellington in midwestern NSW.”

Spiers won the Dr Ross Ingram Memorial Essay Competition for an entertaining and moving description of her efforts to screen prisoners for kidney disease.

Other snippets from the journal include:

• Professor Wendy Hoy, from the University of Qld’s Centre for Chronic Disease, has weighed up the chances of Australia closing the gap in Indigenous life expectancy by 2030, and judged it “probably unattainable”. She argues that it will probably take several generations for Indigenous people’s health to approximate that of non-Indigenous Australians: “Rather than specify an unrealistic time line for aspirational goals, it would be better to focus on shorter-term process measures.”

• A new study showing that Aboriginal people in the NT are far more likely than other Australians to be hospitalised for problems that could have been prevented from reaching hospital with earlier, better treatment. Between 1998-99 and 2005-06, their avoidable hospitalisation rate was 11,090 per 100,000 population, nearly four times higher than the Australian rate of 2,848 per 100,000.

• Andrew Hewett, Executive Director of Oxfam Australia, raises concerns about the slowness of the Federal Government’s response to closing the gap efforts. In March last year, the federal government signed a statement of intent with leading Indigenous health groups, showing its intent to create a national action plan in partnership with peak Indigenous health groups.

“However, after more than a year, we are still waiting for the national plan and the partnership to eventuate,” says Hewett. “Peak Indigenous health groups have created a comprehensive list of targets they would like to achieve in a plan, and are inviting the government to engage with them, as was promised.” Hewett says Indigenous health groups know what to do to be effective. “For instance, the Victorian Aboriginal Health Service in Melbourne has immunisation rates that show an average of 91 per cent of their child patients are fully immunised, compared with rates of less than 50 per cent for Aboriginal children across Victoria.”

• The relative affordability of energy-dense foods (rich in sugars and fats) compared with nutrient-dense foods (such as meat, fruit and vegetables) in remote communities is a major cause of ill health, according to a new study based in one large remote community in northern Australia. The researchers suggest that efforts to improve nutrition should be placed in an economic framework rather than been seen as a matter of individual behavioural change. They conclude “our study highlights the investment that improving nutrition for Indigenous people in remote communities will require.” Meanwhile, other authors note, however, that nutrition issues were not included in the final National Indigenous Reform Agreement of COAG.

• Interventions to tackle smoking by pregnant Aboriginal and Torres Strait Islander women should focus on the social environment and the influences of social networks and partners rather than the traditional predictors of anenatal smoking, a study suggests.

• Lack of local birthing services means pregnant women from Cape York typically have to leave home at 36 weeks to travel to Cairns, meaning weeks away from family and friends “with detrimental social, cultural and financial consequences”. In 2006, 172 women from 14 Cape communities travelled to Cairns to give birth, three-quarters of whom identified as Aboriginal or Torrest Strait Islander.  The researchers say that reopening maternity units at Weipa and Cooktown hospitals would help.

• A new study gives some powerful insights into why so many Aboriginal people find hospitals and other health services daunting, unfriendly and unhelpful.

The news is not all gloomy, however. This article and another one suggest there’s a good news story just waiting to be told about the Inala Indigenous Health Service in Queensland.

The journal also includes pieces from the Australian Indigenous Psychologists Association and Indigenous Dentists’ Association of Australia, as well as organisations representing Indigenous doctors and nurses. That must be a first.

Oh, for some political attention to these issues, rather than worrying so much about health care for the well-heeled.