Australia's Health

On Monday this week I'd been into the local library to do some photocopying. Normally, after that, I'd leave, but this time I had a strong feeling about looking around. My preference was non-fiction, so I looked at the signs on the shelves and found the social and law areas. I don't know just what I was looking for, but that sounded like me. 360-363.9 was Sociology to Social welfare, problems & services – yes, that would be me. I took a couple of books out of the shelf and had a look through them, and the third one really got my eye – it was titled “Australia's Health 2016”, provided by the Australian Institute of Health and Welfare (AIHW). Maybe I would have been counted into whatever they reported.

I checked the book out and took it home to read.

This is the “15^th biennial health report of the Australian Institute of Health and Welfare”, presented in 2016 to (ex) Minister Sussan Ley. All material in this book is covered by the AIHW copyright under Creative Commons - Copyright © Australian Institute of Health and Welfare. Please note that if you will use any of the writing from this book which I have quoted in my blog.

There are seven main chapters:

• An overview of Australia's health
• Australia's health system
• Leading causes of ill health
• Determinants of health
• Health of population groups
• Preventing and treating ill health, and
• Indicators of Australia's health

I moved to Eagleby in November last year. I didn't choose it, but I was mistreated by the retirement village where I'd been for a short time (5 months). For it's population (around 11,900) Eagleby has a lot of retirement villages, including Oxford Crest, Ruby Living Gems, Palm Lake Resort and Sapphire Living Gems and a lot of unemployed people. The unemployment stats were a lot higher than the rest of the country – 12.6% as against 4.9% federally in 2011 - and 47.1% renting against 31.4% federally in 2015. ABC reported in February this year the sort of problems renters have federally with unhealthy rentals, starting with the introduction which said “Let's just say the latest national snapshot of the state of renting a home in Australia does not paint a pretty picture”.

Eagleby is 35.8km away from Brisbane CBD (and only 45.2km from Gold Coast CBD), and it's included in Brisbane's low socioeconomic groups. I'm a DSP recipient due to my stroke with aphasia. Before that I had a job, I had a very good education, but now I can't work so I am included in the low socioeconomic group. This book explains it on page 183 (Chapter 5.1), saying that there is a “composite measure such as the Index of Relative Socio-Economic Disadvantage (IRSD)” based on “low income, low educational attainment, high unemployment and jobs in relatively unskilled occupations”. Chapter 4 looked at 10 facts about social determinants to low socioeconomic people (Box4.1.1, page 130) – bullet point 6 says “A higher proportion of people with an employment restriction due to a disability lived in the lowest socioeconomic areas (26%) than in the highest socioeconomic areas (12%) in 2012 (AIHW analysis of ABS 2012 Survey of Disability, Ageing and Carers)”. Very unfair for people with disability.

Chapter 3 provided a diagram titled “Top five leading causes of premature death, by age, 2011-2013”. 'Premature age' is earlier than your age group might be expected to die. In Australia, it seems, the median age of dying was 82 years old in 2013. Perhaps that's more nowadays. Whatever you belong to (by your age), see if you can identify with deaths within your age group. For me, the 'cerebrovascular disease' includes stroke but doesn't include my age (45-64) – and yet that age includes suicide. Maybe they did know me!

The book looks at stroke in Chapter 3.6 (page 90). My heart had stopped during my brain aneurysm surgery, was re-started, and the stroke happened then. According to the book, 377,000 people throughout Australia had a stroke within their lives (171,000 of those were female), and 71% of those were over 75. The people who had a disability from that fell from 45% in 1998 to 39% in 2012. I have no idea how that would work out for me, but my maths are simple: 29% of 171,000 = 45,590. 39% of that = 17,780. That, to me, is 17,780 females who had a stroke throughout their lives who are now disabled. That, it seems, includes me. It also said that “[d]edicated stroke units in hospitals significantly improve the health outcomes of patients.” Many of those under the age of 75 with aphasia don't seem to improve 'significantly' enough to get back to work.

This chapter also said that “[p]eople living in the lowest socioeconomic areas also had higher rates of stroke”, but it doesn't mention that people who had a stroke have been down-graded and moved to a low socioeconomic area from a medium socioeconomic group.

Chapter 5.9 (a very short 2-page sub-chapter) looks at Health of Australians with disability, but it looks at obesity (70% disabled against 60% non-disabled), lack of exercise (46% against 31%), smoking (31% against 15%) and psychological distress (22% against only 1.2%). This part of the chapter only looks at people aged 15-64 and not older people because, they say, “NHS excludes institutional care settings and therefore underestimates disability prevalence among older people”. The 'excellent/very good' stats have gotten worse since 2007-08, even for “no disability or restrictive long-term health condition”, by 2011-12, but the 'fair/poor' have grown.

Obesity is not precluded by people with disability, but it occurs to people like us because many of us can't meet an exercise limit, we feel psychological distress as we are teased or abused by people in 'normal' positions, and we simply feel that smoking is something we can have control of. What else could we control?

NDIS is not mentioned at all throughout this book, but they have looked, so far, at the National Disability Strategy 2010-2020, and quotes one of the main outcomes as “[p]eople with disability attain the highest possible health and wellbeing outcomes throughout their lives (DSS 2012)”. Previous meetings to 'learn' about NDIS have been written about in my blog before (What will NDIS do for us?, Tuesday 27 October 2015 and NDIS still??, Saturday 15 April 2017). I've seen NDIS too much to even understand it! NDS's 'outcome' quote, above, still doesn't reflect the 'highest possible' recovery for us.

This book is very interesting and very close to 'now'. I've never seen anything like this before (even though it's supposed to have been done every two years), but I think it's confirmed a lot that I now feel about health in Australia, especially to people from low socioeconomic areas. As a person with a disability, I would never have expected to end up here, but I have lived with a disability for the last 3 years. I feel so... frustrated, sad... for the people who have lived in these sorts of areas for most of their lives, either with a disability or a low education. This government – ANY government – owes a decent life to anybody who lives here, regardless whether they are citizens, whether or not they are able to or can work.

I wonder if that will ever happen.