Transcript Launch of Rural Health Week 2013 Panel Discussion

Making Tasmania the healthiest State by 2025 by
social determinants of health pathway - high risk,
high returns
Ms Leonie Young, Inaugural Chair,
Ministerial Health and Wellbeing
Advisory Council, THC, 26-27 July 2014
Introduction
• Rural Alive & Well (Tas) Board Director;
National Chair, Australian Gynae Cancer
Foundation; beyondblue ambassador
• Former CEO of beyondblue: the national
depression initiative, 2003-2010
• Fmr State Manager, DoHA, NT, 2000-2003
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Ministerial Health and
Wellbeing Advisory Council
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Established in 2011 under A Healthy Tasmania
Nine independent community leaders
Voluntary, advisory positions
Multi-sectoral representation (Menzies, TasCoss, Heart
Foundation, Kickstart Arts, Cradle Coast Council,
corporate business, Lifeline, COTA)
• Reported to Cabinet & Govt via Minister for Health
• Secretariat provided by Population Health, DHHS
• Two-year sitting term; Thriving Tasmania Report, 2013
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Advisory Council
Terms of Reference
• Priorities:
– Identify appropriate measures to improve health and
reduce social inequities
– Provide advice on the best approaches to place-based
health and wellbeing
• Roles and Responsibilities:
– Provide expert advice to government based on
individual experience, collective skills, field of interest
– Advocate for action on the underlying determinants of
health and inequity across sectors
– Build the community of interest in A Healthy Tasmania
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Advisory Council’s
Approach
Determinants of Health (Dahlgren & Whitehead, 1992)
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Challenges of Tasmania’s Population - no part
of the Tas pop considered to be an urban centre. The ABS
classifies the majority of Tas as inner or outer regional.
Outer
regional
33.2%
Inner
regional
64.8%
Remote 1.5%
Very remote
0.5%
ABS, Regional Population Growth, Tasmania 2011
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
“People living outside of major cities in
Australia have worse outcomes on leading
indicators of health and access to health
care. They have higher rates of obesity,
smoking and risky alcohol consumption.
Their rates of potentially preventable
hospitalisations are also higher and they
are less likely to gain timely access to aged
care.”
COAG Reform Council 2013
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
“Poverty kills people.”
Late Professor Gavin Mooney.
…Thousands of Tasmanians are dying
prematurely or unnecessarily, and struggling
against ill-health and poor wellbeing to the
detriment of their productivity and our
community.
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Risk factors by remoteness, 2011-12
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Mortality rates by remoteness
(per 1,000 population), 2011
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Rate per 100,000 population
Potentially avoidable mortality from all-causes,
under 75 years, Australia, 2009
350
284.5
300
250
200
150
182.4
139.6
138.9
151.5
143.9
149.2
144.9
118.0
100
50
0
NSW
Vic
Qld
WA
SA
Tas
ACT
NT
Aust
Notes: 1. Rates are age-standardised to the Australian 2001 population. 2. The error bars represent the 95% confidence intervals of the rate.. 3. COAG Reform Council 2012, Healthcare
2010–11: Comparing performance across Australia, COAG Reform Council, Sydney.
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
6 Top Causes of Death: Tas vs Aust
ABS Cat. No. 3303.0, Deaths Australia 2010
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Cancer Mortality
Cancer (all-cause) mortality rates* by
jurisdiction, 2006-10
Statistically significantly higher than all
other jurisdictions (except NT) and
175.4
176.8
177.3
174.8
177.7
NSW
Vic
Qld
WA
SA
215.6
198.9
163.1
Tas
ACT
176.9
NT
Aus
*age-standardised rates per 100,000 population;
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Age-standardised mortality rate
Ischaemic heart disease Tasmania, 1978-2010
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
HWAC findings
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Improving health in Tasmania was not about increasing the number of beds in
hospitals or relocation of health services – less about health servicing consistently more about health system reform and tackling the causes of illness,
sdoh, including:
Improving health literacy; linking IT and patient care systems, improving
collaboration and integration, coordination, access and transport
More investment in education, for adults and children, boosting literacy and
numeracy skills and adopting a cradle to career view;
Increasing rates of employment, tackling long term unemployment with targeted
approaches, providing work-ready and return to work training programs;
Boosting the economy – many regional and rural towns struggling with industry
and business closures, reducing workforce and increasing reliance on welfare;
Improving access to safe and secure, affordable housing, across the state;
Building social engagement – improving people’s connectivity in the community;
Supporting corporate enterprise, encouraging small business development, public
and private sector investment.
Leonie Young, Chair, Ministerial Health and
Wellbeing Advisory Council
Tasmanian Health Conference 2014
Recent progress
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Tasmanian Health Assistance Package (TML)
Medicare Local – SDoH Project
Social Determinants of Health Network
Thriving Families Healthy Communities Program in Community
Houses; establishment of Child & Family Centres
• Joint Parliamentary Select Committee on Preventative Health Care;
SDoH Network; and Health in all policies framework
• Tasmanian Lead Clinician’s Group
– Redevelopment of Tasmania’s Health Plan; THO’s
• Advisory Council’s Mapping Report
– Very high number of health and wellbeing activities happening within
Tasmania; millions of dollars across 3 levels of government plus private
health funding – very little coordination, integration, data linking,
information or resource sharing or collaboration across projects.
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Identified potential opportunities
• Health Literacy programs and initiatives
• Place-Based Approaches – community driven and
resources – with a social determinant’s focus
• Leadership across sectors to align effort:
– Public Health Advisory Council
– State Public Health Plan
• State Policy for Healthy Land-Use and Urban
Planning
• Health intelligence and evidence capability
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Shared urgency of status quo,
risks abound
• Thriving Tasmania - everyone has a role to play
• Insufficient Tas Govt treasury funds to attend to current
levels of illness, disease, mental illness, remedial education
programs, disability, aged care, stroke recovery, juvenile
justice, unemployment and rehabilitation requirements to
name a few of the urgent issues;
• All of us are affected through mortality, morbidity, low
productivity, low economy, low education rates in our
struggling and iniquitous state for our children,
grandchildren and ageing parents; maintain status quo = no
progress
• How to reach goal of Tasmania healthiest State by 2025,
fragmented, body part, separate, silo approach to date
Leonie Young, Chair, Ministerial Health and Wellbeing Advisory Council
Tasmanian Health Conference 2014
Urgency of case, new champions
Urgent Case for change: Evidence-Based Action
– evidence base established, shared goals, informed high level
leadership looking to make a difference
– Population health reports, burden of disease data,
New and existing champions
– New governments, new opportunities, new Premier, Health &
Community Services Ministers, new policies, shared
commitment to statewide action and improving health and sdoh
outcomes, complemented by strong bipartisan support for sdoh
reforms in Tasmania
– partnership in health models, AMA, Menzies, Utas, Medicare
local, primary care infrastructure, bipartisan support, across
sectors, matched by community expectations
Leonie Young, Chair, Ministerial Health and
Wellbeing Advisory Council
Tasmanian Health Conference 2014
Champions, resources, high potential for
state of excellence, healthiest State 2025
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New Tasmanian government elected on a bold and shared commitment to the
community to build a Tasmania we can be proud of; to rebuild health services, to
invest in education to create a job-ready generation; planning to build a modern
economy, a plan to build a prosperous Tasmania; and we now have that
opportunity ….
Together with Federal support, pooled resources, partnerships, collaborative
planning, strong state-wide policies and drawing on support across sectors for a
thriving Tasmania, we can improve our health and sdoh outcomes;
World-wide, national and local examples of improving health, wellbeing,
employment, education, and the economy by engaging communities do exist.
Tasmania, defined by our relatively small population within an island border gives
opportunity for a coordinated, integrated state of excellence; a population health,
shared funding model with the Commonwealth, beyond 3 year election cycles.
We have the urgent case and just now, the right political, community, federal and
state bipartisan support, its not a continuing competition to the bottom, we’ve
won already.
If we start now, building on our shared commitment and shared goals, we can be
the healthiest State by 2025
Leonie Young, Chair, Ministerial Health and
Wellbeing Advisory Council
Tasmanian Health Conference 2014