for several months this was what my
workplace every morning I’d get up and
I’d walk through this gate into naka
Valley Hospital in a very rural area of
Uganda walking through this gate changed
my life and it brought me to where I am
today here in this area of Uganda
malnutrition was so common among
children that it wasn’t even viewed as a
health condition it was just seen as
part of the way that children grow up
but we know that if it’s left untreated
malnutrition has serious consequences
and worldwide a child dies of
malnutrition every six seconds we know
that every single one of these deaths is
preventable so we worked with hospital
staff to set up a malnutrition treatment
center at the hospital to try to avoid
these preventable deaths one of the
first patients that came into the clinic
was Ronnie when his parents brought him
in Ronnie was so weak and malnourished
that he could hardly move and his
parents didn’t think he’d survive even a
few more days the nurses started him on
an infant feeding program and he started
to gain weight and he was discharged
from the hospital within a few weeks so
a few months later we walked through the
villages to visit Ronnie and his family
to see how he was doing we brought along
rations of Plumpy’nut
a therapeutic food to keep him
continuing on his treatment outside of
the hospital when we did a health
assessment of Ronnie we saw that he
still did have signs of malnutrition but
that he was absolutely on the path to
recovery and he’d completely turned
around from just a few weeks earlier
this experience changed my course it was
absolutely heart-wrenching seeing
children so young lose their lives in
the hospital knowing that each one of
those deaths could have been prevented
and I knew that there were thousands of
children like Ronnie out there who might
not have a chance at a healthy childhood
but the success we saw in children like
Ronnie was inspiring and empowering and
from that experience I learned that I
wanted to pursue a career in public
health so that brought me to the
Australian National University where
I’ve been doing population health
research focused on improving the health
and
well being of Aboriginal and Torres
Strait Islander children so before I go
any further I’d just like to follow to
acknowledge the traditional owners of
the land on which we meet the Ngunnawal
people and I’d like to pay my respect to
elders past present and future I like to
acknowledge all Aboriginal and Torres
Strait Islander people who are with us
today I’d also like to take a moment to
recognize my colleague and friend ray
Lovett who’s contributed to the ideas
that I’ll be speaking about today each
color here represents a distinct
Aboriginal or Torres Strait Islander
nation each with their own unique and
distinct cultures and languages many of
these languages are still spoken today
and these cultures are among the oldest
continuing cultures in the world but
these strengths aren’t what we hear
about in the media today so today I’ll
be talking to you about how we currently
report on Aboriginal health and
well-being how we define success and
what we might do instead so when you
think about Aboriginal health the first
thing that probably comes to mind is
closing the gap you might think of all
the areas in which we see deficits
shortfalls and gaps in Aboriginal health
compared to the non-indigenous
population and that’s what we hear in
the news that’s what’s always in the
media and what we tend to hear seems to
always be about the negatives and so
some researchers went out and tested
this so they analyzed media articles
about Aboriginal health to see how many
we’re talking about Aboriginal health in
a positive way a negative way or neutral
so what they found is probably no
surprise overwhelmingly what we hear in
the media about Aboriginal health is
negative more than three-quarters of the
stories focus on Aboriginal health in a
negative way only 15 percent highlighted
any positive elements of Aboriginal
health so what does it matter what does
it matter that we keep hearing about
these negatives in the media first this
perpetuates a negative stereotypes about
Aboriginal and Torres Strait Islander
people and this can fuel discrimination
and racist behaviors second Aboriginal
people can lose self-esteem and can lose
have negative impacts to the social and
emotional well-being from always hearing
about that people told about in a
negative
way they might start to feel shame about
being Aboriginal based on the way that
it’s crip trade in the media and what
this means
both of these can then impact negatively
on factors that we know protect against
our protect our health if you’re afraid
of experiencing discrimination you might
avoid accessing our service or if you do
go to the health service you may be
treated unfairly and not receive
recommended treatment or maybe as a
coping strategy to deal with your stress
and your races experience of the racism
maybe you smoke or use alcohol so that
in turn all of these factors then lead
to poor health outcomes so this constant
focus on the negatives and the gaps only
serves to make these gaps wider and to
repair away this inequality so when we
think about the closing the gap strategy
we define success as when Aboriginal
health matches that of the
non-indigenous population this is
undeniably an important goal and
something to work towards but this
shouldn’t be the only way that we define
success we could just define success as
a time in which we see improvement in
Aboriginal health and well-being without
looking and focusing on this comparison
first so I’ll go through two examples of
when this goal of closing the gap
doesn’t actually align with the school’s
working goal of health improvement so
this graph shows that that that closes
over time if you look in the 1990s the
gap between the two lines is bigger than
the gap is in the 2000s so we take it
closing the gap frame we see this as
success we see that we’ve closed we’re
working towards closing this gap what if
I told you that this gap was showing the
prevalence of gestational diabetes among
Aboriginal mothers and non-indigenous
mothers then is this really what success
looks like what this graph shows us is
that both Aboriginal mothers and
non-indigenous mothers are getting worse
off we see that the gaps closing over
time but that’s only because the health
of non-indigenous mothers is getting
worse more quickly than the health of
Aboriginal mothers so in relative terms
we see that the gap is closing but in
absolute terms both groups are worse off
so to me this is certainly not what
success looks like
so let’s try another example this graph
shows the prevalence of smoking among
Aboriginal dots and the total Australian
population in 1994 2004 and 2014 so we
can see that the prevalence of smoking
has dropped from over 50 percent in 1994
down to about 40 percent in 2014 for our
Aboriginal adults in the total
Australian population smoking stops from
about 30 percent down to 15 percent when
we focus on the gap between these lines
we see that it hasn’t changed much over
the past two decades I each of these
three time points the prevalence of
smoking is about 25 percent higher among
average and little adults so when we
look at this in terms of closing the gap
we might say that there’s been little if
any progress made but what if we told
this story a different way what if
rather than focusing on the gap we
focused on the health of our Aboriginal
and Torres Strait Islander Australians
what if we take away the gap and we take
away the comparison then what we see is
a 14 percent prevalence reduction of
smoking among Aboriginal adults what
this means is that there’s 50,000 fewer
Aboriginal smokers today than they would
have been if the prevalence stayed the
same so what this means is that tens of
thousands of prevent from people through
the smoking reduction so to me that’s
what success looks like when we focus on
the gaps when we focus on the
inequalities we lose sight of the people
that these statistics represent when all
we do is look at the gap we lose sight
of these ten thousands of lives that
have been saved so of course there’s
often times where it’s valuable and
important to compare populations and
there’s absolutely value in the closing
the gap campaign these comparisons and
budget marks help us to see how things
are going to see areas where we might
need extra work and to see where things
are going well but this shouldn’t be the
only way we define success and this
shouldn’t be the only side of the story
that we hear we shouldn’t only hear
these negatives in the media we should
be looking and listening to positive
stories of progress and success and
valuing these stories
so today I challenge you to question the
negatives and the comparisons you hear I
challenge you to find the other side to
that story I challenge you to find what
strengths and successes might have been
left out of the story that you’re
hearing so to me the goal is not to
improve the health of one population
relative to the other to me the goal is
to improve health . so to bring us back
to the beginning at the end of my time
in uganda there was a knock at the door
of the hospital this time it was ronnie
in his family had come to visit us
ronnie was walking and talking and
smiling this time rather than us
bringing ronnie his therapeutic food
Ronnie’s family had brought us a basket
of food from their own very limited
supply to thank the hospital for
changing Ronnie’s life to me this is
what success looks like Ronnie’s success
shouldn’t be discounted compared to
other children who might be doing better
and his progress shouldn’t be forgotten
about just because the malnutrition is
still common in his community to me
Ronnie’s progress and any other health
improvement is something to be
celebrated
you
workplace every morning I’d get up and
I’d walk through this gate into naka
Valley Hospital in a very rural area of
Uganda walking through this gate changed
my life and it brought me to where I am
today here in this area of Uganda
malnutrition was so common among
children that it wasn’t even viewed as a
health condition it was just seen as
part of the way that children grow up
but we know that if it’s left untreated
malnutrition has serious consequences
and worldwide a child dies of
malnutrition every six seconds we know
that every single one of these deaths is
preventable so we worked with hospital
staff to set up a malnutrition treatment
center at the hospital to try to avoid
these preventable deaths one of the
first patients that came into the clinic
was Ronnie when his parents brought him
in Ronnie was so weak and malnourished
that he could hardly move and his
parents didn’t think he’d survive even a
few more days the nurses started him on
an infant feeding program and he started
to gain weight and he was discharged
from the hospital within a few weeks so
a few months later we walked through the
villages to visit Ronnie and his family
to see how he was doing we brought along
rations of Plumpy’nut
a therapeutic food to keep him
continuing on his treatment outside of
the hospital when we did a health
assessment of Ronnie we saw that he
still did have signs of malnutrition but
that he was absolutely on the path to
recovery and he’d completely turned
around from just a few weeks earlier
this experience changed my course it was
absolutely heart-wrenching seeing
children so young lose their lives in
the hospital knowing that each one of
those deaths could have been prevented
and I knew that there were thousands of
children like Ronnie out there who might
not have a chance at a healthy childhood
but the success we saw in children like
Ronnie was inspiring and empowering and
from that experience I learned that I
wanted to pursue a career in public
health so that brought me to the
Australian National University where
I’ve been doing population health
research focused on improving the health
and
well being of Aboriginal and Torres
Strait Islander children so before I go
any further I’d just like to follow to
acknowledge the traditional owners of
the land on which we meet the Ngunnawal
people and I’d like to pay my respect to
elders past present and future I like to
acknowledge all Aboriginal and Torres
Strait Islander people who are with us
today I’d also like to take a moment to
recognize my colleague and friend ray
Lovett who’s contributed to the ideas
that I’ll be speaking about today each
color here represents a distinct
Aboriginal or Torres Strait Islander
nation each with their own unique and
distinct cultures and languages many of
these languages are still spoken today
and these cultures are among the oldest
continuing cultures in the world but
these strengths aren’t what we hear
about in the media today so today I’ll
be talking to you about how we currently
report on Aboriginal health and
well-being how we define success and
what we might do instead so when you
think about Aboriginal health the first
thing that probably comes to mind is
closing the gap you might think of all
the areas in which we see deficits
shortfalls and gaps in Aboriginal health
compared to the non-indigenous
population and that’s what we hear in
the news that’s what’s always in the
media and what we tend to hear seems to
always be about the negatives and so
some researchers went out and tested
this so they analyzed media articles
about Aboriginal health to see how many
we’re talking about Aboriginal health in
a positive way a negative way or neutral
so what they found is probably no
surprise overwhelmingly what we hear in
the media about Aboriginal health is
negative more than three-quarters of the
stories focus on Aboriginal health in a
negative way only 15 percent highlighted
any positive elements of Aboriginal
health so what does it matter what does
it matter that we keep hearing about
these negatives in the media first this
perpetuates a negative stereotypes about
Aboriginal and Torres Strait Islander
people and this can fuel discrimination
and racist behaviors second Aboriginal
people can lose self-esteem and can lose
have negative impacts to the social and
emotional well-being from always hearing
about that people told about in a
negative
way they might start to feel shame about
being Aboriginal based on the way that
it’s crip trade in the media and what
this means
both of these can then impact negatively
on factors that we know protect against
our protect our health if you’re afraid
of experiencing discrimination you might
avoid accessing our service or if you do
go to the health service you may be
treated unfairly and not receive
recommended treatment or maybe as a
coping strategy to deal with your stress
and your races experience of the racism
maybe you smoke or use alcohol so that
in turn all of these factors then lead
to poor health outcomes so this constant
focus on the negatives and the gaps only
serves to make these gaps wider and to
repair away this inequality so when we
think about the closing the gap strategy
we define success as when Aboriginal
health matches that of the
non-indigenous population this is
undeniably an important goal and
something to work towards but this
shouldn’t be the only way that we define
success we could just define success as
a time in which we see improvement in
Aboriginal health and well-being without
looking and focusing on this comparison
first so I’ll go through two examples of
when this goal of closing the gap
doesn’t actually align with the school’s
working goal of health improvement so
this graph shows that that that closes
over time if you look in the 1990s the
gap between the two lines is bigger than
the gap is in the 2000s so we take it
closing the gap frame we see this as
success we see that we’ve closed we’re
working towards closing this gap what if
I told you that this gap was showing the
prevalence of gestational diabetes among
Aboriginal mothers and non-indigenous
mothers then is this really what success
looks like what this graph shows us is
that both Aboriginal mothers and
non-indigenous mothers are getting worse
off we see that the gaps closing over
time but that’s only because the health
of non-indigenous mothers is getting
worse more quickly than the health of
Aboriginal mothers so in relative terms
we see that the gap is closing but in
absolute terms both groups are worse off
so to me this is certainly not what
success looks like
so let’s try another example this graph
shows the prevalence of smoking among
Aboriginal dots and the total Australian
population in 1994 2004 and 2014 so we
can see that the prevalence of smoking
has dropped from over 50 percent in 1994
down to about 40 percent in 2014 for our
Aboriginal adults in the total
Australian population smoking stops from
about 30 percent down to 15 percent when
we focus on the gap between these lines
we see that it hasn’t changed much over
the past two decades I each of these
three time points the prevalence of
smoking is about 25 percent higher among
average and little adults so when we
look at this in terms of closing the gap
we might say that there’s been little if
any progress made but what if we told
this story a different way what if
rather than focusing on the gap we
focused on the health of our Aboriginal
and Torres Strait Islander Australians
what if we take away the gap and we take
away the comparison then what we see is
a 14 percent prevalence reduction of
smoking among Aboriginal adults what
this means is that there’s 50,000 fewer
Aboriginal smokers today than they would
have been if the prevalence stayed the
same so what this means is that tens of
thousands of prevent from people through
the smoking reduction so to me that’s
what success looks like when we focus on
the gaps when we focus on the
inequalities we lose sight of the people
that these statistics represent when all
we do is look at the gap we lose sight
of these ten thousands of lives that
have been saved so of course there’s
often times where it’s valuable and
important to compare populations and
there’s absolutely value in the closing
the gap campaign these comparisons and
budget marks help us to see how things
are going to see areas where we might
need extra work and to see where things
are going well but this shouldn’t be the
only way we define success and this
shouldn’t be the only side of the story
that we hear we shouldn’t only hear
these negatives in the media we should
be looking and listening to positive
stories of progress and success and
valuing these stories
so today I challenge you to question the
negatives and the comparisons you hear I
challenge you to find the other side to
that story I challenge you to find what
strengths and successes might have been
left out of the story that you’re
hearing so to me the goal is not to
improve the health of one population
relative to the other to me the goal is
to improve health . so to bring us back
to the beginning at the end of my time
in uganda there was a knock at the door
of the hospital this time it was ronnie
in his family had come to visit us
ronnie was walking and talking and
smiling this time rather than us
bringing ronnie his therapeutic food
Ronnie’s family had brought us a basket
of food from their own very limited
supply to thank the hospital for
changing Ronnie’s life to me this is
what success looks like Ronnie’s success
shouldn’t be discounted compared to
other children who might be doing better
and his progress shouldn’t be forgotten
about just because the malnutrition is
still common in his community to me
Ronnie’s progress and any other health
improvement is something to be
celebrated
you
Please follow and like us: