Aboriginal community-controlled healthcare improving life expectancy in the NT

Alice Springs town camp resident Eileen Hoosan credits treatment by her local Aboriginal community-controlled health service for having helped stop her diabetes from becoming a full-blown chronic condition.

"I'm being treated for diabetes but I'm a borderline diabetic, thanks to the services I get from Congress," she said.

The 71-year-old worked as a secretary for Central Australian Aboriginal Congress when the organisation was founded 50 years ago, and is also a past board member.

She said now she is one example of how the health service is helping to close Central Australia's Indigenous life expectancy gap.

"I think it's because it's Aboriginal health in Aboriginal hands — it's our organisation, and they're there to support our health needs," she said.

"And going out, taking health services to people is important — it's one of the good jobs that Congress do."

Congress is one of Australia's biggest and longest-running Aboriginal community-controlled health services.

A new study by the Menzies School of Health Research has found that over the past 50 years, Congress's services have succeeded in helping to reduce preventable Indigenous deaths in Central Australia.

"So, Aboriginal men, when Congress started, life expectancy was 47 years, it's now 65, and women are living to 70," Congress acting chief executive John Boffa said.

"Since 2000, the gap's closed nine years for Aboriginal men and four years for Aboriginal women.

"The investment in Aboriginal community-controlled health services is working, health is improving."

Dr Boffa said Congress's reputation had helped encourage patients to seek help early.

"If you provide access to culturally safe, effective healthcare, people come in in very large numbers," he said.

"People want their chronic disease well-managed, they want to be healthy."

The Menzies research found Central Australian life expectancy improvements had resulted from increased primary healthcare funding directed through Aboriginal community-controlled health services, improved investment in hospitals, and alcohol and sniffable petrol restrictions.

However, Dr Boffa said more work is still needed.

NT records largest life expectancy gaps

The Northern Territory still has Australia's largest Indigenous life expectancy gap, where Aboriginal men on average die at 65, while non-Indigenous men die at 79.

Indigenous women in the NT on average die at 69, compared to non-Indigenous women who live to 83.

Those figures compare to the national Indigenous men's life expectancy of 71 and Indigenous women's life expectancy of 75.

"People are still getting sick at rates that are still unacceptable, because prevention requires action beyond the health system,"

Dr Boffa said.

"We've got to address housing overcrowding, education, and lift people out of poverty."

In the NT's Top End, community leaders on Elcho Island, off the Arnhem Land coast, say they are devastated by the number of loved ones they are losing to chronic diseases.

"They are dying, like at only 30, 40, 50, taking heart attacks all the time," Elcho Island resident Helen Guyupul said.

"I am also worrying about diabetes, and cancer and high blood pressure."

Ms Guyupul and other community leaders have worked with the local Gawalnga Aboriginal Corporation to develop a program called Hope For Health, which offers personalised healthy eating coaching to people and information on chronic disease causes in their Yolŋu language.

"We are coaching one another, how we can eat the good food; it was changing the weight, and the sugar level, and the blood," Ms Guyupul said.

Melbourne University research fellow and cardiovascular physiologist Hasthi Dissanayake carried out an evaluation of the program in 2022. 

"By the end of four months, more than half of the participants achieved a reduction in blood glucose of at least 0.3 per cent and more than a quarter achieved a weight reduction of at least 3 per cent of their baseline body weight," she said.

"These thresholds are typically considered clinically significant because they are associated with meaningful reductions in future risk of type 2 diabetes and cardiovascular disease and related complications.

"After a year, on average participants were still more than 2 kilos lighter than when they started."

However, the group has been unable to attract federal or NT government funding to continue the program.

Both governments told the ABC they already provided funding to the region's Miwatj Indigenous health service to provide prevention programs.

"Miwatj Health is responsible for meeting the needs of its community in Arnhem Land … and there is no discretionary funding available for additional grants," an NT Health Department spokesperson said.

The federal Health Department said when the group applied for funding last year, "there were no grant opportunities in scope for the proposal", and it advised the organisation to monitor its website for any future grants it could apply for.

Miwatj Health told the ABC it "provides a range of community-based preventative health programs" to tackle smoking and promote healthy homes and hygiene, and good sexual and mental health.

Gawalnga Corporation chief executive Tim Trudgen said it was a disappointing outcome for the community.

"We really need to have more accountability within government around funding things that are supported by community and known to work," he said.

The federal government has increased funding for Indigenous health services by almost a quarter over the past five years, to reach $1.26 billion a year in 2024-25.

Mr Trudgen said his community's experience is that more help is needed.

"It's difficult to explain what it's like here on the ground — it feels like you hear about a death every week, and over the dry season there was a funeral here almost every week in Galiwin'ku," he said.