In the second installment of The State of Health, JESSICA WILLARD examines a new project being rolled out across Launceston's Northern Suburbs.
In Tasmania, the number of people with chronic conditions such as heart disease, diabetes, cancer, stroke and asthma continues to increase.
Now, communities are starting to take matters into their own hands by implementing local, grassroots initiatives in an effort to improve the health of residents.
With state and federal funding, the Our Community, Our Care project is a joint venture between the Northern Suburbs Community Centre and Ravenswood Starting Point Neighbourhood House, with research from the University of Tasmania.
Based on the concept of anticipatory care, the project involves community members across Launceston's Northern Suburbs getting personally involved in improving the health and wellbeing of the community.
What is anticipatory care?
Anticipatory care was first recognised in the 1960s in the United Kingdom and the Netherlands.
Here, GPs found that by taking a population approach to anticipating the needs of their patients, and considering where social or other needs might best be met, it resulted in significantly better health outcomes than those in neighbouring communities.
As senior research fellow for the anticipatory care project Dr Susan Banks explained, it's about understanding and addressing why people need to go to a GP in the first place.
"Anticipatory care has had more attention in the UK," she said.
"It was the idea of a GP in Britain who said: 'people come in here and I treat them, but then I send them home to the same conditions that made them sick. It's this idea that we know there are certain risk factors out there, what can we do to reduce them.
"So we are anticipating the health needs of people in the future. We are looking at what we can do to address that now, rather than waiting for them to get sick."
In Tasmania, four communities are taking part in the anticipatory care project: Ulverstone; Flinders Island; Clarence; and Launceston's Northern Suburbs.
The project brings together the Australian Prevention Partnership Centre, the Tasmanian Health Department, UTAS researchers, Primary Health Tasmania and the Tasmania Health Service, to explore what anticipatory care is already being undertaken and what could work more broadly.
Why has the Northern Suburbs been chosen?
Generally, people from lower social or economic circumstances are at a greater risk of poor health outcomes.
The Northern Suburbs have been identified as having higher than average Tasmanian rates of diabetes, smoking, being overweight or obese and physical inactivity, along with higher rates of potentially preventable hospitalisations.
In Mowbray, Invermay, Newnham, Waverley and Ravenswood, more than 25 per cent of people over 18 are estimated to be smokers, compared to the statewide average of 18.9 per cent and national average of 16 per cent. About 6.7 per cent of Northern Suburb residents aged between 25 and 64 have diabetes, 67.6 per cent are obese and more than 28 per cent have high blood pressure.
Invermay (19.8 per 1000 people), Newnham and Mayfield (14 per 1000), also have higher rates of potentially preventable hospitalisations related to chronic illness than the state overall average (11.6 per 1000).
There is also a high prevalence of asthma, arthritis, hypertension and poor oral health, with incidents of anxiety, depression and mental illness higher than average.
However, while social isolation and access to economic resources remain issues, Dr Banks said Northern Suburbs community members were engaged in creating change.
"We know from our qualitative data that family is important to people here," she said.
"People know their neighbours, and there are networks of support, as well as two strong neighbourhood houses with large numbers of volunteers.
"People are working to cover the gaps that are either smaller or non-existent in some other places."
So, what's being done?
Last month, the Our Community, Our Care project was officially launched with a series of public forums, aimed at engaging local residents and service providers.
The project's advisory group, consisting of about 30 people and led by Dr Frank Madill AM, will now work to identify what steps could be taken to help improve health outcomes, with the support of UTAS researchers.
With a number of preventative health initiatives already in place in the Northern Suburbs, Dr Madill said the project was aimed at identifying what was missing.
"I read a statistic the other day that by 2060, 40 per cent of the Tasmanian population will be over 65. That in itself is going to put huge challenges as to how we are going to keep them in good health for longer, without any other factors," he said.
"There is a lot of chronic health out there, that just isn't being addressed, but people don't recognise it. If they do recognise it, they don't do anything about it. If they want to do something about it, they don't know how.
"There is a whole range of reasons this chronic health burden in our community is one that we have to find ways of minimising and decreasing the load."
With the challenge set, Northern Suburbs Community Centre manager Denise Delphin OAM, said it, along with Ravenswood Starting Point Neighbourhood House, were committed to supporting change.
"Both of our organisations already provide lots of activities and services to support the health and wellbeing of our communities, but we know there are always things we can improve and build on," she said.
Dr Banks said while health outcomes in the Northern Suburbs were poor, it didn't signify a failing of the community, with many factors beyond the control of residents.
"Obviously there's habits that people have, but there is a lot evidence that even smoking and drinking are cultural matters and nothing to do with people's understanding that those things are bad for them," she said.
"We know that there is a link between ill-health and socio-economic status, so it is really important not to think that they are somehow failing as human beings. Because there's actually a lot of other forces at play, that would make anybody unhealthy.
"It's not just that there aren't enough GPs or bulk billing, which there isn't. It's also the other things that might contribute to a person's ability to be healthy. It's questions like: is there a shop that sells fresh food cheap and that's easy to get to? Are there safe places to do exercise?
"Where do people go when they have a health problem? Is it the internet, the pharmacy, or do they go to the GP. And at what point in the development of a condition do they go to a GP. We know it is often a bit too late. These are the questions we need to answer, if it is going to change."
For more information, visit the Our Community Our Care Facebook page.