We’ve heard a lot about health inequity recently, and rightly so. The solutions are, in large part, political, ideological and economic but how should we deal with health inequalities on the ground, when we are confronted with excess illness and disability, and early death?
The post below is a great example of a health program that emerged from community-identified need, and a willingness to listen and respond in very practical ways to the problem of Aboriginal women in the Shoalhaven area being disproportionately affected by chronic diseases.
The Dead or Deadly program is the subject of a report published online recently. Below is some background, and a sneak preview.
Bronwyn Fredericks, Marlene Longbottom, Karen McPhail-Bell and Faye Worner write:
The Waminda Aboriginal Women’s Health Service (Waminda) is determined to support Aboriginal Australian women in the Shoalhaven region to take their health into their own hands, and assist in closing the health disparity gap between Indigenous and non-Indigenous people.
The rhetoric of Closing the Gap has set Australia on a path towards redressing the enormous health inequities and inequalities experienced by Aboriginal and Torres Strait Islander people. In practice, progress has been disappointing with only two of the seven Close the Gap targets on track to be met, 10 years on from the campaign’s beginning.
The state of New South Wales (NSW) is no exception, where 70% of the health inequality between Indigenous and non-Indigenous people in NSW is accounted for by preventable chronic conditions including cardiovascular disease, diabetes, chronic respiratory disease and cancer. Most vulnerable are Indigenous women, the most socially and economically disadvantaged population group in Australia.
Dead or deadly: Responding to inequity
Waminda has responded to this inequity through community controlled, culturally appropriate services and a culturally safe environment provided through a program called Dead or Deadly. Dead or Deadly began in 2010 in response to the need identified by Aboriginal women in Shoalhaven for an ongoing, frequent and intensive health and fitness program.
Waminda delivers Dead or Deadly according to its vision for women and their Indigenous families to be positive, happy and healthy. Under this vision Indigenous women are admired and proud of their achievements in their own communities – and a recently released research report has found that the approach is working.
At the time of writing the report, 150 women had participated in personalised, holistic health and wellbeing programs, with group exercise, health education and camps.
In addition, more than 300 Indigenous women have participated annually in community events linked to Dead or Deadly such as pamper days, sports events and other activities. These community events support access to health information, opportunistic screening, tailored health and fitness advice, and support to quit smoking.
Dead or Deadly is a holistic program focussing on four areas: physical activity; nutrition/diet information; smoking cessation; and chronic disease prevention and management. A constant, cyclical approach to community consultation and involvement continues to shape the program.
Local solutions, positive changes
This new report discusses the components of the holistic model of health at the heart of the Dead or Deadly program, which enables Waminda to address their clients’ numerous health and related life issues, while creating pathways to and opportunities for Waminda’s other health and clinical services to support these clients.
The study found that Dead or Deadly is leading to positive changes in the clients’ health and wellbeing, including physical health, employment, self-esteem, family, education and cultural connection – amongst other things. Dead or Deadly plays an important role in enabling Waminda to deliver health services according to a holistic model of health, long-recognised as essential for improving Indigenous health.
The report reaffirms the evidence that Aboriginal Community Controlled Health Services (ACCHOSs) provide the best returns on investment for providing access to health services and the quality of those services. However, despite the successes of Dead or Deadly, the program has repeatedly risked closure due to lack of funding, and fixed term funding offered at the ‘11th hour’.
Aboriginal and Torres Strait Islander people and communities have the solutions for their own health. State and federal governments must work together to ensure funding mechanisms align with the evidence-based call to support holistic, Indigenous-led initiatives such as Dead or Deadly.
The report was written in collaboration with the Waminda Research Committee of the Waminda South Coast Women’s Health and Welfare Aboriginal Corporation. We thank the committee for their dedication and involvement. We also acknowledge two studies that provided material analysed and referred to by the report: firstly, the Shoalhaven Koori Women Study led by Ms Marlene Longbottom; and secondly, Mr Scott Winch’s evaluation of the Dead or Deadly program. Finally, we thank CQUniversity’s Office of Indigenous Engagement and the Centre for Tourism and Regional Opportunities (CTRO), The Healing Foundation and the National Indigenous Research and Knowledge Network (NIRAKN) for their support.
Fredericks, Bronwyn, Longbottom, Marlene, McPhail-Bell, Karen and Worner, Faye, in collaboration with the Board of Waminda. (2016). Dead or Deadly Report. Waminda Aboriginal Women’s Health Service. CQUniversity, Australia: Rockhampton, Queensland, Australia. 32 pages. ISBN: 9781921047169.
*Bronwyn Fredericks is Pro Vice-Chancellor (Indigenous Engagement) and BHP Billiton Mitsubishi Alliance Chair (BMA) in Indigenous Engagement, Central Queensland University @BronFredericks; Marlene Longbottom is Indigenous New Career Academic, Wollotuka Institute, University of Newcastle. @MLongbottom13; Karen McPhail-Bell is a Research Worker, Central Queensland University. @solomon_kazza Faye Warner is CEO, Waminda South Coast Women’s Health & Welfare Aboriginal Corporation @WamindaSthCoast.