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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Source: DEEWR (unpublished); ABS—see Appendix D.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Source: Mortality in the NT, Health Gains Planning, 2012 (unpublished)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)
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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?