ACCOs: Aboriginal Community Controlled Organisations
ACCHOs: Aboriginal Community Controlled Health Organisations
ACCHSs: Aboriginal Community Controlled Health Services
AH&MRC: Aboriginal Health and Medical Research Council of NSW
CAH: Centre for Aboriginal Health, NSW Ministry of Health
CAPO: NSW Coalition of Aboriginal Peak Organisations
CEE: Centre for Epidemiology and Evidence, NSW Ministry of Health
CTG: Closing the Gap
HREC: Health Research Ethics Committee
KPI: Key performance indicator
LGA: Local Government Areas
LGBTQI+: Lesbian, gay, bisexual, transgender, queer/questioning and intersex
LHD: Local health district
NGO: Non-government organisation
PHN: Primary Health Network
PRA: Priority reform area
SD: Strategic direction
SHN: Specialty health network
Aboriginal health means not just the physical wellbeing of an individual but refers to the social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential as a human being, thereby bringing about the total wellbeing of their community. It is a whole-of-life view and includes the cyclical concept of life-death-life1.
Co-creation differs from co-design, as it allows people to collaboratively identify problems, which extends on co-design where issues are already pre-defined and on co-production where both problems and solutions are pre-defined148.
The commercial determinants of health are private sector activities affecting people’s health, directly or indirectly, positively or negatively. Commercial activities by private sector organisations shape the physical and social environments in which people live and work, and are a key determinant of Aboriginal peoples’ and communities’ health and wellbeing149.
The cultural determinants of health are anchored in Aboriginal ways of knowing, being and doing, centred upon the relationship of self to Country, kin, community, and spirituality. They are rights-based, as they hinge upon the inherent right to practice one’s Aboriginal culture, including through: connection to Country, family, kin and community; Aboriginal beliefs and knowledge; cultural expression and continuity; Aboriginal language; and self-determination and leadership150.
Cultural safety is an Aboriginal and Torres Strait Islander specific concept in Australia. It is an experience that Aboriginal and Torres Strait Islander peoples have and its presence or absence can only be determined by them151, 152, 153, 154. A culturally safe environment for First Nations people is when their presence is welcomed and respected, experiences are believed and validated, cultures are centred and valued, knowledges and skills are recognised and supported, advice is listened to and acted upon and they do not experience racism in any form155. Culturally safe care and services do not discriminate, are respectful, safe and enable meaningful communication and shared decision making. Cultural safety is defined by the individual interacting with the system and receiving care.
The economic determinants of health focus on the effects of government policies and social norms on Aboriginal peoples’ and communities’ ability to gain employment, advance in the workforce, access capital, establish and expand businesses, accumulate and protect wealth, manage financial risk, and pass wealth on intergenerationally156.
NACCHO describes environmental health as ‘a science- based, action-oriented technical practice that addresses disease risk arising from environmental conditions’157.
A sustained focus on environmental health reduces rates of preventable illness.
Health justice is the process of advancing health equity158 through breaking down the structural and systemic barriers that lead to health inequities.
Health equity is ‘the absence of unfair, avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, geographically or by other dimensions of inequality (e.g., sex, gender, ethnicity, disability, or sexual orientation)’ and can be achieved when everyone can attain their full potential for health and wellbeing159.
‘Health literacy is about how people understand information about health and health care, and how they apply that information to their lives, use it to make decisions and act on it’160. Individual health literacy means what individuals know and understand about health and the health system so they can make decisions about their own healthcare and how to navigate the health system. Health systems have a responsibility to create environments that support individuals to develop good health literacy.
The health system in NSW refers to all health organisations across the state combined. This includes the public health services of NSW Health, private health services (primary care, hospitals, medical specialists and allied health), Aboriginal Community Controlled Health Services and mainstream primary care services.
Knowledge translation is ‘the series of interactions we have with people to connect research outcomes to making needed changes in policy, programs and practice’161.
NSW Health organisations consist of:
This refers to the health of human civilisation in terms of the state of the natural systems on which it depends163. By acknowledging the dependence of global human health on natural systems, including in terms of averted cases of disease, planetary health explicitly accounts for the potential harm that comes from human-caused perturbations (disturbances) of these systems164.
The planetary determinants of health refer to climate change, and the technological, industrial and policy changes needed to mitigate and adapt to it, are a central focus of planetary determinants-led approaches to health.
The political determinants of health refer to Aboriginal communities’ ability to practice collective self- determination by deciding and implementing their own policy agendas, through their own governance structures, and according to their own systems of law and lore165.
The priority population groups in this Plan include young people, Stolen Generations survivors and their descendants, people living with disabilities, people living in regional and remote areas of NSW, LGBTQI+ people, incarcerated people, older people and Elders.
The positive and sustainable long-term benefit for Aboriginal peoples, which is gained from research outside of any academic benefits for individual researchers and research organisations166.
Social determinants of health refer to the material conditions of people’s lives that are shaped by structures beyond their personal control167. They are non-medical factors that influence health outcomes. For Aboriginal peoples, racism is a social determinant of health in addition to those commonly acknowledged by the World Health Organization, such as income, education, employment, job security, housing, food security, early childhood development, transport and social support and exclusion.
Decision-making is shared between government and Aboriginal and Torres Strait Islander people. Shared decision-making is:
Strategic workforce planning is the process of identifying and bridging gaps between current and required future workforce needs to meet strategic goals and objectives. It enables organisations to proactively understand and plan for changes that may impact their work and workforce whilst mitigating risks and embracing opportunities. Strategic workforce planning is about understanding and proactively preparing for changes that may impact the workforce. Strategic workforce planning identifies actions that address workforce challenges, risks, and opportunities. Strategic workforce planning is longer term planning –often covering a 3 to 5 year period. Strategic workforce planning is separate from operational and tactical workforce planning, although strategic workforce planning informs the other two processes169.