Aboriginal Health Profile 2019 WESTERN NSW PRIMARY HEALTH NETWORK

We acknowledge that we work on the traditional lands of many Aboriginal clan groups and nations. We commit to working in collaboration with our region’s Aboriginal communities and peoples to improve their health, emotional and social wellbeing in the spirit of partnership.

Aboriginal nations within our region include:

• Barindji • Kamilaroi • Wailwan • Barkandji/ • Muruwari • Wilyakali Paakantji • Muthi Muthi • Wiradjuri • Barranbinya • Ngemba • Wongaibon • Barundji • Ngiyampaa • Gunu • Nyampa In this publication the term ‘Aboriginal’ is used to describe the nations, clan and language groups across NSW including all Aboriginal and Torres Strait Islander people within this area.

OUR POPULATION Local Government AGE PROFILE Areas with the The Aboriginal population of our highest total 10.5% region is younger than the non- proportion of Aboriginal population. identify as Aboriginal people Aboriginal people, include Brewarrina, of Aboriginal people with 31,455 people Our PHN has the third are aged under 25 years highest national proportion Central Darling, 53% living in the region compared to 33% of all who identify as Aboriginal Bourke, Coonamble identifying as people in the region. Aboriginal people people, behind the Northern and Walgett. Territory and Western in the last census. WNSW PHN Population Pyramid Queensland PHNs. Aboriginal and total population, 2016 Census

OUR POPULATION Aboriginal Total Population

LIFE ABORIGINAL NON-ABORIGINAL 65 years and over EXPECTANCY 45-64 years MALES MALES 25-44 years OF PEOPLE 70.5yrs 79.8yrs

Age group 15-24 years

BORN IN NSW, FEMALES FEMALES 0-14 years 74.6yrs 83.1yrs 2010-2012 40.0 30.0 20.0 10.0 0.0 10.0 20.0 %

EARLY YEARS Child and Maternal Health Mortality in children aged 0-4 years in Fully immunised children WNSW PHN, Low birth weight babies, 2017 in WNSW PHN, 2016-2017 2009 to 2013

Western NSW PHN NSW Age Aboriginal Children All Children 45% higher Aboriginal Non-Aboriginal Aboriginal Non-Aboriginal 1 year 92.9% 95.3% mortality mothers mothers mothers mothers rate 2 years 88.8% 93% 11% 6% 11% 7% 5 years 97% 96% in Aboriginal children aged There were 80% more low birth weight babies born to WNSW PHN has the 6th highest fully 0-4 than non-Aboriginal Aboriginal mothers in the region than the same for non- immunised coverage for Aboriginal children children (5-year average Aboriginal mothers. aged 5 years. mortality rate). CHRONIC DISEASE Nationally, 3 leading chronic • Cardiovascular 56% diseases in Aboriginal Cardiovascular Disease Dialysis hospitalisations of Aboriginal People living in the People are: disease for Aboriginal people region reported having • Diabetes hospitalisations for in Western NSW PHN two or more long-term health • Chronic Aboriginal people in Western NSW PHN were were more than conditions. Almost 10% higher than • Kidney Disease double the rate of 7 times the rate for the same for the total Australian non-Aboriginal non-Indigenous people. Aboriginal population. people. (5-year average) (5-year average)

MENTAL HEALTH Aboriginal people in NSW had almost twice The NSW rate of suicide among the rate of high or very high psychological Aboriginal people aged 15 to 24 distress, including anxiety, depression, agitation years was double that for and psychological fatigue compared with non- non-Aboriginal people from Aboriginal people. 2012 to 2016. The 5-year average rate of Aboriginal Aboriginal people hospitalisations for mental disorders 19% in WNSW PHN is double that for non- 11% Non-Aboriginal people Aboriginal people.

CANCER HOSPITALISATIONS Lung cancer was the most common The rate of all hospitalisations for Aboriginal form of cancer and people living in our region is double that for caused the most cancer non-Aboriginal people. deaths of Aboriginal people between 2008 Top 2 causes of hospitalisations for Aboriginal people are: and 2012, nationally.

7x Dialysis 2x Respiratory Potentially preventable Seven times higher disease hospitalisations for than that for non- Twice the rate of Aboriginal People. non-Aboriginal Aboriginal people in our people. region are 2.7x HEALTH RISK FACTORS that of non-Aboriginal people.

61% 42% 29% Almost half of potentially preventable hospitalisations in Australia 61% of Aboriginal people 42% of Aboriginal people 29% of Aboriginal people are due to causes relating to aged 16 years and older aged 16 years and older aged 16 years and older chronic conditions (COPD, heart were overweight or were insufficiently were current smokers failure, cellulitis, kidney & urinary obese compared with physically active, equal compared with 15% for tract infections and diabetes 52% for non-Aboriginal to that of non-Aboriginal non-Aboriginal people in complications). in NSW. people in NSW. NSW. CARE SERVICES

The number of The number of 18% increase Aboriginal Health Practitioners GP Health Assessments in Aboriginal recipients of has increased from for Aboriginal people aged care services. 16 (2013) to 65 (2015) has increased by 15%

of the region’s The majority of telehealth services telehealth users were for Aboriginal people living 23% identified as in Bourke, Dubbo, Wellington, Aboriginal. Brewarrina and Walgett.

SOCIOECONOMIC HEALTH DETERMINANTS

Factors which impact health

Social and Household weekly 48% fewer There were twice as On school entry economic income was Aboriginal people many Aboriginal in NSW, 35% disadvantage – 19% lower completed Year households in of Aboriginal in 2016 more for Aboriginal 12 or equivalent NSW with 6 or children were than half of people than non- level of schooling more residents developmentally Aboriginal Aboriginal people compared to non- compared with vulnerable people in our living in NSW, 2016. Aboriginal people non-Aboriginal compared with region lived in in NSW, 2016. households in 2016. 19% of non- areas ranked Aboriginal children amongst the most in 2015. disadvantaged in NSW.

TOP FIVE HEALTH CONCERNS Aboriginal people living in our region listed their top top health concerns as:

Alcohol and Mental Aboriginal Cancer Diabetes drug use health health SERVICE GAPS Aboriginal people living in our region listed their top service needs as:

Medical Access to GPs Hospital access Transport and Mental health specialists travel distance to services medical services

MOST HIGHLY RATED SERVICE IMPROVEMENTS NEEDED Aboriginal people living in our region listed their most important service improvements needs as:

More Drug and More Access to Reduced GPs alcohol specialist hospitals waiting services services times

TRAUMA

Trauma, including intergenerational, as a result of domestic violence, and the historical and current disconnection from family, country and cultural practice were seen as significant contributors to those with drug and alcohol issues and mental illness, especially for people who have been in prison.

JUSTICE HEALTH ALMOST 25% 65% 2/3 2/3 TOP 5

Aboriginal people of patients in had a daily substance have received a reported chronic are overrepresented custody have abuse problem diagnosis for a conditions for in the justice system experienced or and 69% reported mental illness at patients in custody making up 25% witnessed traumatic consuming alcohol in some stage in their was: Allergies, of people in events a quantity and pattern life Asthma, Back custody that was deemed problems, Hepatitis hazardous (likely to C and High blood result in harm) pressure

WNSW PHN would like to thank the Aboriginal Health Council for their assistance in the creation of this document. Call 1300 699 167 wnswphn.org.au

Dubbo Broken Hill Bathurst Orange Bourke

(Head Office) 12. Hospitalisations in PHN 2012/13 - 2016/17 HealthStats NSW: ABORIGINAL HEALTH PROFILE 2019 DATA SOURCES Available at: http://www.healthstats.nsw.gov.au. Accessed: 4/12/2018. SECTION 1: INTRODUCTION AND ABORIGINAL 13. Centre for Epidemiology and Evidence. HealthStats NSW. Sydney: POPULATION NSW Ministry of Health. Available at: www.healthstats.nsw.gov.au. Our Population, 2016 Accessed 20/12/2018. 1. Public Health Information Development Unit, 2016 ‘Social Health Atlas of Australia: Data by Primary Health Network.’ Published Cancer November 2018. Available at: http://www.phidu.torrens.edu.au. 14. AIHW analysis of Australian Cancer Database. Accessed: 4/12/2018. Available at: https://canceraustralia.gov.au/affected-cancer/atsi/

cancer-statistics. Accessed: 17/01/2018. SECTION 2: GENDER, AGE STRUCTURE, POPULATION PYRAMID AND LIFE EXPECTANCY ​Hospitalisations Age profile of our region, 2016 15. 2012/13 to 2016/17 HealthStats NSW: 2. Public Health Information Development Unit, 2016 ‘Social Health Available at: http://www.healthstats.nsw.gov.au. Accessed: Atlas of Australia: Data by Primary Health Network.’ Published 4/12/2018. November 2018/ Available at: http://www.phidu.torrens.edu.au. Accessed: 4/12/2018. Health risk factors Life expectancy of people born in NSW, 2010-2012 16. HealthStats NSW: 3. HealthStats NSW: Available at: http://www.healthstats.nsw.gov.au. Accessed: Available at: http://www.healthstats.nsw.gov.au. Accessed: 4/12/2018. 4/12/2018.

SECTION 3: EARLY YEARS Care services 17. Health Intelligence Unit Western NSW Market and Services Analysis Low birth weight babies, 2017 June 2017. 4. HealthStats NSW:

Available at: http://www.healthstats.nsw.gov.au. Accessed: 4/12/2018. Telehealth, 2016-2017 18. Health Intelligence Unit Western NSW Market and Services Analysis Fully immunised children in WNSW PHN, 2016-2017 5. Healthy Communities: Immunisation rates for children in 2016-17. June 2017. Available at: www.myhealthycommunities.gov.au. Accessed: 4/12/2018. Factors which impact health 19. ABS 2016 Census of Population and Housing Aboriginal and Torres Mortality​ in children aged 0-4 years, 2009 to 2013 Strait Islander Peoples Profile Catalogue number 2002.0. 6. SAPHaRI, NSW Ministry of Health and Health Intelligence Unit Available at: http://www.censusdata.abs.gov.au/census_services/ Western NSW Health Needs Assessment 2017. getproduct/census/2016/communityprofile/1?opendocument. Accessed: 18/09/2017. SECTION 4: CHRONIC DISEASE 20. Australian Institute of Health and Welfare (2016). Canberra. Children’s headline indicators (CHI) 2016 (Indicator 10: Transition Chronic disease to primary school) Children Developmentally vulnerable on one or 7. Australian Institute of Health and Welfare 2015. Cardiovascular more domains of the Australian Early Developmental Census 2015. disease, diabetes and chronic kidney disease— Australian facts: Available at: https://www.aihw.gov.au/reports/children-youth/ Aboriginal and Torres Strait Islander people. Cardiovascular, diabetes childrens-headline-indicators/contents/dynamic-data-displays. and chronic kidney disease series no. 5. Cat. no. CDK 5. Canberra:

AIHW. Top five health concerns, service gaps and service improvements 8. Circulatory disease hospitalisations 2012/13 - 2016/17 HealthStats 21. Community Health Survey for Western NSW Primary Health NSW: Network, August 2018. Available at: http://www.healthstats.nsw.gov.au. Accessed: 4/12/2018. Trauma 9. Dialysis hospitalisations 2012/13 - 2016/17 HealthStats NSW: 22. WNSW Needs Assessment Consultation Workshops Final Report, Available at: http://www.healthstats.nsw.gov.au. Accessed: 4/12/2018. 2018”

10. Australian Bureau of Statistics (2013), 2012-13 Aboriginal and Torres Justice health Strait Islander Health Survey, cat. no. 4727.0.55.001 23. Justice Health and Forensic Mental Health Network Patient Health Available at: http://www.health.gov.au/internet/main/publishing.nsf/ Survey, 2015. Content/PHN-Aboriginal_Data. Accessed: 17/01/2018. Available at: https://www.justicehealth.nsw.gov.au/

publications/2015_NHPS_FINALREPORT.pdf. Accessed: 04/12/2018 Mental health 24. Australian Bureau of Statistics, 2016 ‘Prisoners in Australia’. 11. Western NSW PHN 2012/13 - 2016/17 HealthStats NSW: Available at: http://www.abs.gov.au. Accessed: 04/12/2018. Available at: http://www.healthstats.nsw.gov.au. Accessed: 4/12/2018.