Module 1.1 the Ministry Context: Church, Health and Care in Australia

Module 1.1 The ministry context: Church, Health and Care in Australia

Australia is changing.

Change in population Australia’s population is projected to grow from 25.5 million people today1, to 40 million by 2048 with almost two thirds of this coming from migration.2 The 2016 census showed more than a quarter of the population was born overseas, with increasing migration from countries outside of Europe.3 If you want to know the diversity of your local community visit SBS ‘How diverse is my suburb?’ for ancestry, age, religion and birthplace. https://www.sbs.com.au/news/interactive/how-diverse-is-my-suburb

Like the rest of the world Australia’s population is ageing. There were 3.1 million people in Australia aged 65 years and over in 2011 (which is about one in seven people (16% in SA). 4 The 2010 Intergenerational Report forecasts the proportion of our population aged over 65 will increase from 14% (Australia wide) in 2010 to 23% by 2050.5

Number and proportion of the population aged 65 and over, by age group and sex, 30 June 2017, 2027, 2037, 2047 and 2057 6

Change in religious affiliation Changes in religious affiliation result from changing social values and attitudes, increased secularisation in the last three decades with increasingly larger numbers of Australians identifying as ‘not affiliated with any religion’. Young people are more likely to report not having a religion (39%) and more likely to be affiliated with religions other than Christianity (12%) than other adults.7 In the 2016 the question in religious affiliation was optional with 4.9% of people non responding. Religious affiliation is affected by migration, with the proportion of people born overseas who were affiliated with a religion other than Christianity 21% was considerably higher than for those born in Australia 3.7% respectively.8 The percentage of Australians identifying as ‘Christian’ has decreased from 88% in 1966, to 74% in 1991, and declining to 52% in 2016.9 The number of people reporting a non-Christian faith is increasing considerably, from around 2.6% of the population in 1991 to 8.2% (1.9 million people) in 2016. 10

Religion Percentage of Number of Percentage of population people population in 2016 2016 2006 Christian 52.1% 12,201,600 63.9% Islam 2.6% 604,200 1.7% Buddhism 2.4% 563,700 2.1% Hinduism 1.9% 440,300 0.7% Sikhism 0.5% 125,900 0.1% Judaism 0.4% 91,000 0.4% Other non Christian 0.4% 95,700 0.5% No religion 30.1% 7,040,700 19%

Table11

Change in social context

Life expectancy is rising and with it the level of people living in the community who are elderly is also rising. Only 5% of older Australians live in aged care facilities.12 Many older people are fit and well, but others are not.

Most of these elderly people live with their life-partner, but one quarter live alone in private dwellings, and this increases with age.13 In 2011 23% of men and 40% of women aged 80 and over live alone.14

Almost one in five older people (19%) need assistance with one or more of the core everyday activities of self-care, mobility or communication, which increases with age.15 Most assistance to older people living at home is provided by informal carers (73%) such as family, and formal providers give 60% of the services but this varies depending on the activity.16 Activity type and provider type for older Australians aged 65 and over living in households who needed assistance, 201517

How this assistance is provided needs to consider the cultural diversity of the community which is reflected in the ageing population and their varied needs.

The deinstitutionalisation of people living with disability, the frail aged, those with chronic mental or physical illness means many live in the community, but not all are networked into supportive communities, so social isolation increases as frailty increases.18 Loneliness and social isolation top the list of main concerns for older people living at home.19

Social isolation is also caused by an older workforce, more dislocation of extended families where parents and children may live far away from each other, and changes in family demographics. “In June 2012, there were 961,000 one parent families, making up 15% of all families and 81% were mothers with children”20 A recent Australian report stated 1 in 10 Australians aged over 15 report lacking social report and 1 in 2 feel lonely at least 1 day each week.21 Social isolation and loneliness can be harmful to people’s emotional, mental and physical health – it is a comparable risk for early death as smoking 15 cigarettes per day.22 People can be alone when they have serious health issues and this can increase their suffering. For research, ideas and resources on reducing social isolation visit Campaign to End Loneliness UK https://www.campaigntoendloneliness.org/

Change in health care Population growth will create the need for more health services different models of health care and a different makeup of the health workforce.23

Health care in Australia is changing. There is ongoing restructure to deal with the increase in demand for services, which will place more pressures on limited resources. We are experiencing more early discharge from hospital and less qualified carers looking after sicker people in the community. Health care costs are always rising and the State tax system will not be able to sustain this growth. 24 This will probably mean a change in standards and expectations regarding tax payer funded services. The rise in ‘user pays’ services will heighten access and equity issues for those who are poor and disenfranchised.

The rise in people living with chronic disease adds to the burden on our health system. For example, “the cost of type two diabetes is projected to increase by more than 520% between 2002–03 to 2032–33”.25 Consequently, economists predict health costs will increase from 15% of all Commonwealth Government spending, which is currently 4% of GDP, to 26% by 2050, which is 7.1% of GDP.26 Things have to change. There is no choice.

Issues such as the need to reduce expectations of consumers and purchasers of care services, the need to change the health workforce skill mix, the recognised need for continuity of care to reduce duplication and improve

coordination, are all factors driving the refocusing of Australia’s health system.27

Please note, there is also disparate health and access to services between Indigenous and non-Indigenous Australians. In 2008 the Australian governments began working together on ‘Closing the Gap’ aiming to improve the lives of all Aboriginal and Torres Strait Islander Australians by delivering better health, education and employment.28 For more information see https://closingthegap.niaa.gov.au/

Opportunities for churches

Rather than a problem to be feared we can view all this as an important opportunity for churches to re-engage with health, healing and pastoral care ministry that promotes health and wellbeing, prevents disease, and to restore wellbeing when they have chronic conditions so people can live full and purposeful lives.

Having health professionals based in the faith community and preparing pastoral health and care workers is an essential plank in the ministry platform of an effective planned response to meet this looming need. For example, vulnerable populations such as people living with mental health disorders need social relationships to maintain good health. Our churches have much to offer this population in order to transform their lives!

Considering the Biblical principles of justice, stewardship and the command to love our neighbour, especially the most vulnerable, as followers of Jesus Christ we are called to respond and prepare ourselves as individuals and churches to support during these times of change.

References after Covid-19 Addendum and please see separate Word document list of references so you can click the links.

Addendum Covid-19 effects on health and pastoral care

At the time of writing and filming the long-term effects of Covid-19 pandemic on health, finances, travel etc are still unknown, and most of the world is still in some form of ‘lock down’ for social isolation. This is what is known so far in Australia:

There is rising mental distress. Families are overwhelmed and under pressure. There has already been a rise in requests for DV assistance requests and use of mental health and suicide prevention services.1 There are concerns for an increase in addiction.2

Many Australians are experiencing financial distress from unemployment and business closures, and its flow on effects on housing. World-wide financial market losses will affect self-funded retirees and superannuation of current workers. The cost of government economic measures is yet to be realised.

The government has also raised concern for people living with chronic conditions not accessing their usual medical services or medications with a potential rise in unmanaged chronic illness.3 Anecdotally a physio shared they are expecting to see decrease in mobility and rise in falls as older people have not been outside engaging in activities or in gyms maintaining muscle strength and balance.

There will be growing need to for loss and grief support as people come to terms with loss of jobs, housing, anticipated special events such as weddings, 90th birthdays, the once in a life time overseas holiday, being present at the birth of a baby, and the shattering of our sense of control and freedom. For those who experienced the death of a loved one during the restrictions they have not able to have the ritual of a large funeral or hugs of support.

Resource: Humanitarian Disaster Institute, ‘Preparing your church for Coronavirus (Covid-19) A step-by-step, research informed and Faith-Based manual’https://www.wheaton.edu/media/humanitarian-disaster- institute/Preparing-Your-Church-for-Coronavirus.pdf

References 1. Australian Bureau of Statistics (ABS), ‘Population Clock’, ABS, Canberra, viewed 27 April 2020, https://www.abs.gov.au/AUSSTATS/[email protected]/Web+Pages/Population+Clock ?opendocument&ref=HPKI 2. M McCrindle, Australia’s population to each 25 million, McCrindle, 2018, viewed 27 April 2020, https://mccrindle.com.au/insights/blog/australias- population-to-reach-25-million/ 3. ABS, ‘Census of Population and Housing: Reflecting Australia – Stories from the census – Cultural Diversity in Australia 2016’ ABS, Canberra, June 2017, viewed 29 April 2020, https://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/2071.0~20 16~Main%20Features~Cultural%20Diversity%20Article~60 4. ABS, ‘Where and How do Australia’s Older people live’, ABS, Canberra, 2013, viewed 20 November 2013. http://www.abs.gov.au/ausstats/[email protected]/Lookup/2071.0main+features6020 12-2013 5. Commonwealth of Australia, ‘A National Health and Hospitals Network for Australia’s Future’, Canberra, 2010, viewed 21 November 2013, p. 3. http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nhh n-report-toc/$FILE/NHHN%20-%20Full%20report.pdf 6. Australian Institute of Health and Welfare (AIHW), ‘Australia’s welfare 2017 in brief – Ageing and aged care’, Australian Government, Canberra, Oct 2017, viewed 29 April 2020, https://www.aihw.gov.au/reports/australias- welfare/australias-welfare-2017-in-brief/contents/ageing-and-aged-care 7. ABS, ‘Census of Population and Housing: Reflecting Australia - Stories from the Census 2016 - Religion in Australia’, ABS, Canberra, June 2017, viewed 27 April 2020, https://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/2071.0~20 16~Main%20Features~Religion%20Data%20Summary~70 8. Ibid 9. Ibid 10. Ibid 11. Ibid and ABS, ‘2006 Census of Population and Housing: Media Releases and Fact Sheets’, ABS, Canberra, June 2007, viewed 27 April 2020, https://www.abs.gov.au/ausstats/[email protected]/7d12b0f6763c78caca25706 1001cc588/6ef598989db79931ca257306000d52b4!OpenDocument 12. Australian Institute of Health and Welfare (AIHW), ‘Australia’s welfare 2017 in brief - Ageing and aged care’, Australian Government, Canberra, Oct 2017, viewed 29 April 2020, https://www.aihw.gov.au/reports/australias- welfare/australias-welfare-2017-in-brief/contents/ageing-and-aged-care 13. ABS, ‘Where and How do Australia’s Older people live’, ABS, Canberra, 2013, viewed 29 April 2020,

http://www.abs.gov.au/ausstats/[email protected]/Lookup/2071.0main+features6020 12-2013 14. D De Vaus & L Qu, L. (2015). ‘Australian Family Trends No. 6 - Demographics of living’, Australian Institute of Family Studies, Melbourne, 2015, viewed 29 April 2020, p. 5. https://aifs.gov.au/sites/default/files/publication-documents/aft6.pdf 15. ABS, ‘Where and How do Australia’s Older people live’, ABS, Canberra, 2013, viewed 29 April 2020, http://www.abs.gov.au/ausstats/[email protected]/Lookup/2071.0main+features6020 12-2013 16. ibid 17. ibid 18. Australian Ageing Agenda, ‘Loneliness leading concern for older people’, Australian Ageing Agenda, 2013, viewed 20 November 2013. http://www.australianageingagenda.com.au/2013/09/12/loneliness- leadingconcern-for-older-people/ 19. Ibid 20. ABS, ‘One Parent Families’, Australian Bureau of Statistics. Canberra, May 2013, viewed 20 November 2013. http://www.abs.gov.au/ausstats/[email protected]/Products/4233AA5C03E81053CA 257B5D0013C807?opendocument 21. AIHW, ‘Social isolation and loneliness’, Australian Government, Canberra, Sep 2019, viewed 29 April 2020, https://www.aihw.gov.au/reports/australias- welfare/social-isolation-and-loneliness 22. Campaign to End Loneliness, ‘Loneliness Research’, Campaign to End Loneliness, UK, viewed 29 April 2020, https://www.campaigntoendloneliness.org/loneliness-research/ 23. Commonwealth of Australia, ‘A National Health and Hospitals Network for Australia’s Future’, Canberra, 2010, viewed 21 November 2013, p. 3. http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nhh n-report-toc/$FILE/NHHN%20-%20Full%20report.pdf 24. Ibid 25. Ibid 26. Ibid 27. AM Van Loon, ‘Faith Community (Parish) Nursing’, in MR Cobb, CM Puchalski and B Rumbold, Oxford Textbook of Spirituality in Healthcare, Oxford Textbooks in Public Health, UK, 2012, pp. 219-226. 28. National Indigenous Australians Agency, ‘Closing the gap’, Australian Government, Canberra, viewed 29 April 2020, https://closingthegap.niaa.gov.au/

Addendum References:

1. S Morrison (Prime Minister of Australia), ‘Media release: $1.1 billion to support more mental health, Medicare and domestic violence services’, Prime Minister of Australia Canberra, 2020, viewed 27 April 2020, https://www.pm.gov.au/media/11-billion-support-more-mental-health- medicare-and-domestic-violence-services-0 2. Alcohol and Drug Foundation, ‘Coping with coronavirus (Covid-19)’, Alcohol and Drug Foundation, Melbourne, 2020, viewed 27 April 2020, https://adf.org.au/covid-19/ 3. G Hunt (Minister for Health), ‘Looking after people with existing health conditions during Covid-19’, Greg Hunt Federal Member for Flinders/Minster for Health, Somerville, 2020, viewed 27 April 2020, https://www.greghunt.com.au/looking-after-people-with-existing-health- conditions-during-covid-19/