1. The HPF report: a compendium of data for policy and planning Tracy Dixon Indigenous Analyses and Reporting Unit Australian Institute of Health and Welfare

2. What is the HPF? Aboriginal and Torres Strait Islander Health Performance Framework Designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) and guide policy and planning

3. Goal of the HPF …to ensure “that Aboriginal and Torres Strait Islander peoples enjoy a healthy life equal to that of the general population that is enriched by a strong living culture, dignity and justice.”

4. HPF and indicator development Extensive consultation process during 2005/06 Based on the National Health Performance Framework Recognises the contribution that individuals and communities make to their own health Acknowledges holistic view of health Recognises that sustainable health gain requires contribution from other sectors Revised following review in 2011

5. What we measure 68 indicators in 3 tiers Tier 1: Health status and outcomes Health conditions Human function Life expectancy and wellbeing Deaths Tier 2: Determinants of health Environmental factors Socio-economic factors Community capacity Health behaviours Person-related factors Tier 3: Health system performance Effective / appropriate / efficient Responsive Accessible Continuous Capable Sustainable

6. The reporting process Biennial reporting, beginning 2006 Extensive analyses by AIHW drawing from over 60 separate data sources Most recent results as well as trends over short and longer term Two main reports: – policy report (prepared by PM&C; previously by OATSIH) – detailed analyses report (prepared by AIHW) Also jurisdictional reports on request

7. 3,000 pages 2,000 tables and figures

8. What can the HPF tell us? Good news – Avoidable mortality decreasing, and the gap closing – Circulatory and respiratory disease mortality declining, and the gap closing – Infant and child mortality declining, and the gap closing – Literacy and numeracy gaps narrowing – Chronic disease management rates improving – Access to pharmaceuticals improving – Number of Indigenous women accessing antenatal care increasing

10. Proportion of Indigenous primary health care services providing chronic disease management

11. Proportion of mothers attending at least one antenatal care session

12. What can the HPF tell us? Continuing concerns: – Gap in cancer mortality widening – No improvement in death rates from external causes (accident, self-harm, violence) – Overweight, physical inactivity rates increasing – Half of Indigenous mothers smoke during pregnancy – Indigenous people still more likely than non-Indigenous people to: Require kidney dialysis Eat no fruit or vegetables Smoke tobacco Be unemployed Experience violence, child abuse and neglect Have contact with the criminal justice system Have problems accessing health services Not have private health insurance

13. But don’t we know this? Reports targeting specific topics are often very detailed Information on a range of issues can be hard to find Major strength of the HPF is pulling it all together in one place, identifying gaps and considering policy implications HPF takes a different perspective on the information so that we can provide answers to broader policy questions about Indigenous health and how to close the gap

14. What next? HPF 2014/15 currently in preparation In the future we are keen to explore new data and new ways of looking at existing data – Australian Health Survey – LSIC and other longitudinal sources – Modelling? – Links between the tiers e.g. antenatal services, behaviours in pregnancy and low birth weight

15. Thank you Tracy Dixon Indigenous Analyses and Reporting Unit Australian Institute of Health and Welfare www.aihw.gov.au