What strikes you when you enter one of Institute for Urban Indigenous Health (IUIH) clinics is the joy of the patients — Elders, men and women, are using the gym, to the constant encouragement of their trainers.
Dotted all over south-east Queensland, these are one-stop shops for health for Indigenous people which are making waves within the Indigenous community.
The clinics include Medicare, dental, gyms and trainers, and supervised medical plans by GPs — and the model is clearly working toward closing the life expectancy gap.
Aunty Kaye Long has diabetes and other health problems, but she now comes regularly and her health is improving.
She says she feels comfortable in this place.
This health strategy is important for this part of the country as it will have the highest population of Indigenous people within five years, overtaking western Sydney.
So with this in mind, the IUIH started establishing clinics in the suburbs of Brisbane with higher Aboriginal populations.
Chief executive Adrian Carson and his team started with five clinics and 8,000 patients but the organisation has since grown to encompass 19 clinics and more than 30,000 patients — with a staggering 2,500 per cent increase in health checks since 2009.
Noel Pearson says circumstances need to change before a solution can be found. (Supplied: Referendum Council)
Explaining the ongoing disadvantage of Aboriginal and Torres Strait Islander people in Australian society, Cape York leader Noel Pearson recently told the ABC that leaders in power have insufficient knowledge of the issues.
“Individuals who hold 95 per cent of the power in Indigenous affairs have about 5 per cent of the knowledge, while those with 95 per cent of the knowledge have about 5 per cent of the power,” he said.
“Until those circumstances change, we will not find effective solutions to this ongoing disadvantage.”
Tackling this power imbalance has occupied the thoughts of Aboriginal innovators for decades now, and Mr Carson and his colleagues from the IUIH are no exception.
In the 1970s, Aboriginal leaders — recognising the inability of the mainstream health system to provide effective healthcare to Aboriginal and Torres Strait islander communities — successfully advocated for Aboriginal-controlled and managed health services (ACCHOs) across the country.
In south-east Queensland, four such services were established but the individual organisations rarely collaborated and their clinics were often situated in areas where Aboriginal families had once lived, in the 70s and 80s, but had long since moved on from.
Enter the IUIH’s vision of empowering Aboriginal and Torres Strait Islander communities.
Success based on three simple concepts
Adrian Carson and his team started with five clinics and 8,000 patients. (ABC News: Greg Nelson)
The IUIH has become arguably the most innovative and responsive ACCHO in the country and it is no coincidence that the region it serves is the fastest growing Indigenous population in Australia, with some 65,000 people.
More Indigenous people live in this region than in the Northern Territory, Victoria, or South Australia and it is soon to overtake Western Sydney as having the highest concentration of Indigenous people in the country.
The IUIH’s success is based on three simple concepts.
First, the critical importance of preventative health and delivering services directly to the community — to the streets, schools, shopping centres and sporting events where Aborigines live, work and play rather than waiting for people to get sick and come to them.
The second idea was that if you give Aboriginal people good health information and the knowledge and power to manage their own health, they will do so.
Smoking, drinking, sedentary lifestyles and poor diets would decrease and over time the rate of chronic disease and mortality would follow.
“We were told that our people didn’t care about their health, that our people didn’t want to go and get their health checks, that our people didn’t care about their babies,” Mr Carson said.
“But, when you provide good services, and put those services in the locations where they need to be, and make sure that there’s a cultural framework by which those services are being delivered, people use the services and start to take control of their own health.”
And the third principle advocated giving full control to Aboriginal people over their own health services — a principle which guided the early pioneers of Aboriginal-community controlled health and a principle that remains essential to closing the gap today, according to Mr Carson.
“The kind of outcomes that we need to change in Indigenous health requires Indigenous people to make decisions about how they live — their own decisions about their own health care,” he said.
“[This] means fundamentally that Aboriginal and Torres Strait Islander people must be in control of those services, the design of those services and how they engage with their community.”
System shows ‘extraordinary’ results, potential for expansion
So, what impact has the IUIH’s innovative health model had on slowing down the spiralling rates of Aboriginal chronic disease in south-east Queensland?
The data has been crunched and the results are extraordinary.
Five years of this new model of care has seen an improvement in health adjusted life expectancy for the IUIH’s patients of nearly a full year.
It is a result Mr Carson is naturally proud of and one that, in a sea of pessimism, gives him and his staff confidence the life expectancy gap can be closed.
“It’s massive. The narrative in this country has been a kind of hand wringing about how we’re never going to close the gap but, in the space of five years, the Institute and our community have demonstrated that we can close the gap,” Mr Carson said.
However, the lessons from the IUIH’s extraordinary success are not just for the Indigenous health sector.
The model of care developed by the IUIH, based on prevention and empowering patients, has profound lessons for mainstream health if adopted.
It is just another example of Aboriginal innovation with the potential to benefit all Australians.