Department of Health is a Smoke Free Workplace Closing the Gap: The NT is doing well Dr Christine Connors A/Director Health Development Branch NT Department.

Department of Health is a Smoke Free Workplace

Closing the Gap: The NT is doing well

Dr Christine Connors

A/Director Health Development Branch

NT Department of Health

August 2013

OverviewSocial determinantsEpidemiologyOutcomesFuture directions

3

Socio-economic quintile by Indigenous status, NT and Australia    

Source: Infancy to young adulthood, Health Gains Planning, 2012 (In Press)

Figure 5.2 Trajectories for Indigenous Year 12 or equivalent attainment, 2006–2020

NSW Vic Qld

WA SA Tas

ACT NT Aust

Source: DEEWR (unpublished); ABS—see Appendix D.

58.5

74.3

49.8

55.90

20

40

60

80

100

2006 2011 2016 2020

2011 result:

Pe

r ce

nt

62.7

81.5

56.4

61.5

0

20

40

60

80

100

2006 2011 2016 2020

2011 result:

63.6

80.8

57.9

62.5

0

20

40

60

80

100

2006 2011 2016 2020

2011 result:

44.6

59.5

39.6

45.3

0

20

40

60

80

100

2006 2011 2016 2020

2011 result:

48.5

66.0

42.7

50.7

0

20

40

60

80

100

2006 2011 2016 2020

2011 result:

60.4

69.9

57.2

57.9

0

20

40

60

80

100

2006 2011 2016 2020

2011 result:

69.8

80.7

66.2

71.1

0

20

40

60

80

100

2006 2011 2016 2020

2011 result: 21.330.2

18.3

28.7

0

20

40

60

80

100

2006 2011 2016 2020

2011 result:

47.452.8

69.0

53.9

0

20

40

60

80

100

2006 2011 2016 2020

2011 result:

Trajectory

Actual

Above trajectory

Below trajectory

Trajectory

Actual

Above trajectory

Below trajectory

Trajectory

Actual

Above trajectory

Below trajectory

Trajectory

Actual

Above trajectory

Below trajectory

5

6

DALY (mortality and morbidity) 1999- 2003

7

COAG Reform Council report. Healthcare 2011-2012: Comparing performance across Australia. May 2013

9

2002 to 2006

0

2000

4000

6000

8000

10000

12000

14000

16000

0-4

5-9

10-

14

15-1

9

20-2

425

-29

30-3

4

35-3

9

40-4

4

45-4

9

50-5

455

-59

60-6

4

65-6

9

70-7

4

75+

Age group (years)

NT Indigenous maleNT non- Indigenous maleAustralia male

1967 to 1971

0

2000

4000

6000

8000

10000

12000

14000

16000

0-4

5-9

10-

14

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

Age group (years)

Deaths per 100,000 population

All cause age-specific death rate, males, by Indigenous status, Northern Territory and Australia, 1967 to 1971 and 2002 to 2006 

Source: Mortality in the NT, Health Gains Planning, 2012 (unpublished)

10

2002 to 2006

0

2000

4000

6000

8000

10000

12000

14000

0-4

5-9

10-

1415

-19

20-2

425

-29

30-3

435

-39

40-4

445

-49

50-5

455

-59

60-6

465

-69

70-7

475

+

Age group (years)

NT Indigenous femaleNT non Indigenous femaleAustralia female

1967 to 1971

0

2000

4000

6000

8000

10000

12000

14000

0-4

5-9

10-

1415

-19

20-2

425

-29

30-3

435

-39

40-4

445

-49

50-5

455

-59

60-6

465

-69

70-7

475

+

Age group (years)

Deaths per 100,000 population

All cause age-specific death rate, females, by Indigenous status, Northern Territory and Australia, 1967 to 1971 and 2002 to 2006

Source: Mortality in the NT, Health Gains Planning, 2012 (unpublished)

11

Death rates by State and Territory 2007-2011

COAG Reform Council report. Healthcare 2011-2012: Comparing performance across Australia. May 2013

12

Rates of potentially preventable and potentially treatable deaths 2007-2010

Figure 1.1 Average annual change in Indigenous death rates per 100 000 from 1998 to 2011 and change required to meet 2031 target

Average annual change

1998–2011

Average annual change

required from 2011 to meet

2031 target

Indigenous Non-Indigenous Indigenous

NSW ns -6.5 -34.4

Qld -18.0 -10.1 -40.7

WA ns -9.2 No published target

SA ns -6.8 -29.2

NT -47.0 -10.8 -47.1

Total -12.2 -7.8 -40.3

Note: ns No significant change. Source: ABS—see Appendix D.

COAG Reform Council report. Healthcare 2011-2012: Comparing performance across Australia. May 2013

COAG Reform Council: Indigenous Disadvantage 2013

Figure A.6 Death rates per 100 000 standard population, 1998–2031, Northern Territory

Source: ABS and AIHW—see Appendix D.

0

500

1000

1500

2000

2500

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

2021

2022

2023

2024

2025

2026

2027

2028

2029

2030

2031

Rat

e pe

r 100

000

Actual IndigenousProjected Indigenous rateIndigenous variability bandsActual non-IndigenousProjected non-Indigenous rateIndigenous trend 2006-2011Indigenous trend 1998-2011

COAG Reform Council report. Healthcare 2011-2012: Comparing performance across Australia. May 2013

16

Preventable hospitalisations due to chronic conditions

COAG Reform Council report. Healthcare 2011-2012: Comparing performance across Australia. May 2013

17

Reduced AMI 2007-2010

16 CQI Facilitators

3 Pre existing

7 New: ACCH

6 New: DoH

19

Trend of Indigenous clients in the NT DoH with type 2 diabetes and heart disease on a care plan

20

Delivery of diabetes services in NT 2005-2012

0

20

40

60

80

100

% S

ervi

ce d

eliv

ery

1 2 3 4

Service delivery to patients with Type 2 Diabetes mellitus(n=number of health centres; number of patient records)

Audit cycle

(n=22;572) (n=22;552) (n=22;582) (n=22;672)

21

Diabetes audits Aboriginal PHC services

22

Diabetes audits NT Aboriginal PHC services

0

5

10

15

20

25

30

35

40

45

50

BP<130/80 HbA1c <7%

NT 2003

NT 2004

NT 2005

NT 2006

NT 2008

NT 2009

NT 2010

NT 2011

National

23

Variation in intermediate outcomes outcome

HbA1c control (<7%)

BP control (<130/80mmHg)

24

Improve social determinants Prevention of obesity Tobacco control Patient and family education

self management support; rehabilitation

Improved clinical care case conference coordination of care CQI

Priorities in chronic conditions

25

Any questions?