POLICY RESEARCH PAPER Healthy Women – Healthy Communities Copyright February 2005 National Rural Women's Coalition PO Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 NRWC– Health and Well Being of Rural Women February 2005 Table of Contents Table of Contents .............................................................................................................................2 Executive Summary .........................................................................................................................3 1. Consulting with rural women....................................................................................................5 2. Depression and mental health in rural areas.............................................................................6 3. Healthy Communities...............................................................................................................8 4. Access to Services....................................................................................................................9 5. Maternity Services..................................................................................................................11 6. Foetal Alcohol Syndrome.......................................................................................................12 7. Women affecting change........................................................................................................13 8. Family Violence .....................................................................................................................14 9. NRWC Position......................................................................................................................15 10. Recommendations ..................................................................................................................16 11. References ..............................................................................................................................17 National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC -2- NRWC– Health and Well Being of Rural Women February 2005 Executive Summary The National Rural Women’s Coalition (NRWC) was formed in June 2002 and comprises the following member organisations: • • • • • • • • A rural Indigenous Woman Australian Local Government Women's Association Australian Women in Agriculture Ltd Country Women's Association of Australia Foundation for Australian Agricultural Women National Rural Health Alliance Rural Doctors Association of Australia (Women’s Section) Women's Industry Network Seafood Community The NRWC is funded through the Office for Women (OFW). A key element of our contract with the OFW is to provide policy advice to the Australian Government. As rural women, our objective is to ensure better social and economic outcomes for women living in regional, remote and rural Australia. Consultation with rural women has been the primary driver of all NRWC activity since its inception in 2002. The NRWC prides itself on the robustness of these consultations and the variety of strategies undertaken to capture the voice of women in rural, regional and remote Australia. This Paper outlines the key communication methods and, most importantly, expands on the ‘Healthy Women – Healthy Communities’ forum hosted by the NRWC which attracted over 150 rural women and community stakeholders. These consultations and in particular, the success of the rural women’s health forum, provided invaluable and fundamental feedback from ‘grass roots’ women. The Healthy Women – Healthy Communities Forum Report outlining the process and outcomes of the 2 day Forum is available through the NRWC Office. To enhance this valuable anecdotal evidence, the NRWC provided partial funding for the ‘Rural Women’s Indicator Project’ conducted through the Rural Social Research Unit at the Charles Sturt University (CSU) in Wagga Wagga. The involvement of the NRWC, through resources and access to national networks, allowed the research to expand to include national sampling. Additionally, NRWC funded a literature review to compile contemporary research and empirical data to further expand on the key areas of concern voiced by rural women. This research has been invaluable and will certainly complement the longitudinal, cohort-based, research undertaken by the Australian Women’s Health Network. In the following report, the NRWC presents the key recommendations from rural women which have arisen through our consultations, surveys and the NRWC national forum addressing the health and wellbeing of rural women. The recommendations are supported by the above research and will be advocated by the NRWC through the appropriate departments, stakeholders and Ministers. National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC -3- NRWC– Health and Well Being of Rural Women February 2005 A gendered approach to health and wellbeing in rural areas is important. Increasingly feminist critiques have challenged medical discourse. Women are the most frequent users of health services, have problems caused by stereotypical roles and experience more disease or illness than men. The issues raised in the following paper reflect the most common concerns highlighted through NRWC consultations and research. These include: a. Depression and mental health, b. Healthy Communities, c. Access to Services, d. Maternity Services, e. Foetal Alcohol Syndrome, f. Family Violence and g. Women as agents for change. The NRWC believes that supporting rural communities and developing policies that enhance capacity building is the key to long term success. Community capacity building is a whole of community responsibility and should incorporate a collaborative approach including government, non government organisations and community stakeholders. The NRWC is committed to using its unparalleled access to state and national women’s networks to promote the recommendations made by rural women. Further, the NRWC, as a fully funded body under the Australian Office for Women, will work in partnership with government and nongovernment organisations to promote the needs of women in maximising their health and wellbeing in rural Australia. The NRWC would like to thank the rural women, medical practitioners, allied health professionals, service providers and government and community stakeholders who provided such valuable contributions to our project. We hope you enjoy the following Position and Policy Paper. It clearly states the position held by the NRWC in relation to the health and wellbeing of rural women and identifies what activities the NRWC will undertake to progress the key areas of concern. Importantly, the paper also outlines the recommendations that the NRWC wish to make to government on behalf of rural women. Healthy Women create and contribute to healthy families and communities. By investing in women’s health, particularly in the rural context, we are investing in stronger families and communities. Women are the most frequent users of health services, have health problems caused by stereotypical roles and experience more illness or disease than men. National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC -4- NRWC– Health and Well Being of Rural Women February 2005 1. Consulting with rural women The NRWC is committed to widespread communication and consultation with rural women. This occurs in a number of ways within the NRWC and is part of NRWC’s inclusive and collaborative approach to policy discussion. Fundamentally, the NRWC consults with rural women through the NRWC’s member bodies. Through the member organisations, NRWC is able to communicate with approximately 200,000 individuals through regular newsletter articles, email and internet. In addition to this internal communication, the NRWC has developed a robust strategy for external communication. We recognise that many rural women are not members of non government organisations and we strive to keep these women informed of NRWC activities and projects. The NRWC achieves this through targeting rural media, particularly rural radio. The media activity surrounding the consultation for the NRWC Healthy Women-Healthy Communities included the following: • media releases, • 12 regional radio interviews, • 15 minute talkback segment on ‘Bush Telegraph’ and • A televised panel discussion. Through this integrated approach, the NRWC was able to communicate with rural women and encourage them to participate in the Healthy Women-Healthy Communities project. Women participated in NRWC’s online discussion boards; forwarded their experiences and recommendations to the NRWC office and many women completed the CSU survey. Most importantly however, 150 rural women and stakeholders attended the 2 day NRWC national forum on the health and wellbeing of rural women. Their feedback and valuable contributions were vital to the processes that resulted in the recommendations contained within this Policy Paper. “(I most valued)… sharing information and knowledge and using this to formulate direction for government policy; feeling we might be able to make a difference.” Direct quote from Forum Participant Evaluation Form National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC -5- NRWC– Health and Well Being of Rural Women February 2005 2. Depression and mental health in rural areas One of the key issues identified through the NRWC consultations and the national forum, was that of mental well-being in rural areas. The direct and indirect nature of depression and mental health on rural women is particularly concerning. Recent stressors such as commodity prices and the drought have caused immeasurable stress on rural women and their families, which in turn has an adverse effect on their ability to contribute to rural communities. It is important to consider the social determinants of health when looking at mental health in the rural context. Socio-economic factors impacting on health include income levels, education, employment and the quality of the physical and social environment1. Whilst access to services and the importance of communities in rural Australia will be considered in this paper, it is important to note that rural women self-elected depression as one of the key issues of concern. Rural women have identified their own stress and mental health as an issue. However as the primary carer in families, rural women have also identified the mental health of their loved ones as a major concern for them. Research conducted through CSU indicates that 53% of rural women felt that mental health services in their area are difficult to access and 43% found it difficult to access counselling in their area. This reflects the findings of the NRWC Forum where rural women identified the following specific concerns: the impact of mental and emotional health problems on physical health, the lack of mental health practitioners in rural and remote areas, the lack of information and knowledge about how to get help, pre-teen and teenage mental health issues and women as caregivers will often put their own needs second to the needs of other family members. During the NRWC Health Forum, the participants were particularly disturbed by statistics provided through beyondblue: a national depression initiative. Statistically there is a significant rising trend towards depression in the 15-24 year old age range, particularly in young males2. For rural mothers, sisters and wives this can impact on their own wellbeing, particularly where access to services and information is poor. Further, rural women have less access to post natal depression services and information3. A recent study comparing service access by rural or urban adolescents, found that structural disadvantage in rural areas had most impact on health status and also limited service use, particularly of mental health services4. National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC -6- NRWC– Health and Well Being of Rural Women February 2005 Rural women have identified social isolation as a major issue in rural areas. Whilst isolation may be real in a geographical sense, many rural women reported their concerns for those who become socially isolated in rural areas. During the NRWC Health Forum, the importance of community, and contributing in community activities, was raised consistently in conjunction with discussion on mental health and well-being in rural areas. A survey of rural General Practitioners (GPs) by the Hunter Valley Mental Health Service identified depression as the most commonly seen mental disorder in general practice and that GPs felt there was a lack of psychological services to deal with depression in rural areas. Media Release Hunter Health 13/2/04 National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC -7- NRWC– Health and Well Being of Rural Women February 2005 3. Healthy Communities The concept of place and community are extremely important in rural women’s health selfassessments5. Consistently rural women place importance on social and environmental conditions in their health self-assessments and the rural context is an important factor in satisfaction, dissatisfaction and wellbeing. The role of rural women in their communities is one of reciprocity and inter-connectedness. High levels of social capital have been linked with a general feeling of well-being. Importantly, low levels of community participation are linked with low incomes and low self-assessed mental and physical health6. It has been reported that social capital, once established, crosses barriers of disadvantage, gender and class and has the capacity to increase the well-being in all sectors of the community7. Invariably women volunteer in greater numbers than men in support of community programs and this is often in addition to their other employment and familial responsibilities. The responsibility for community sustainability and support therefore becomes the responsibility of women. The level of support provided to communities through volunteer work has been widely reported. The CSO Research has highlighted that whilst 79% of respondents were in the paid workforce, 66% of respondents noted that they volunteer in some capacity in their community. This enthusiasm of rural women to keep their communities and community services functional conveys the value of rural communities to the residents. Rural women attending the NRWC Health Forum strongly recommended that the NRWC advocate for improved funding of rural community services. It was strongly recommended that government should focus on developing rural community capacity and services through integrated and multi-faceted solutions. Rural women felt that a holistic approach to building rural workforces and supporting rural community capacity should be a primary aim of government in considering the health and well being of rural Australians. Approximately 30% of rural women volunteer over 5 hrs a week in their rural communities. CSU ‘Rural Women’s Indicator Project’ 2004 National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC -8- NRWC– Health and Well Being of Rural Women February 2005 4. Access to Services The NRWC’s extensive consultations with rural women identified access to services possibly the most significant issue of concern when considering health and wellbeing in rural areas. The inadequate funding of services in rural areas has resulted in limited facilities that offer restricted services8. Whilst the people working in these health facilities are dedicated professionals coping as well as they can, lack of funding is impacting on the services they can provide. Rural women have reported that accessing services, particularly specialist services, is a major impediment in maintaining optimal health and wellbeing in rural areas. Treatment often necessitates staying away from home to receive specialist services, often without family support and incurring financial costs. A lack of public transport and affordable private transport has been consistently noted as a significant factor in access to health services for rural dwellers9. It has been reported that rural women have fewer visits to General Practitioners (GP) and specialists, a greater likelihood of being overweight, a higher level of alcohol consumption and a greater likelihood of gynaecological surgery10. Locally available services tend to be more expensive in rural than urban areas and GP consultations are less likely to be bulk-billed11. Throughout the NRWC Health Forum, rural women also identified the need for greater communication and information about existing services. Whilst telecommunication services has improved access to information for all Australians, geographical remoteness and lower income levels continues to impact on access in rural areas. Transport difficulties are a substantial barrier for all rural communities. The CSU Research highlighted that a high 66% of respondents noted that they need to travel to a regional centre to access health services but 84% stated that public transport is not available to this centre. Transport is a particularly serious issue in Indigenous rural communities12. Older, less educated and Indigenous rural dwellers are the least likely to access health services, particularly if they have low incomes and restricted transportation. Many rural women stated the perceived lack of confidentiality as an issue affecting the access of services in rural areas. Many women felt uncomfortable discussing private medical issues with a service provider that they know on a social basis in their community. Many women also perceived that confidentiality in rural areas as tenuous in very small communities. Services for the aged and for carers in rural Australia seemed to be particularly lacking. The CSU Research indicates that 72% of respondents have the responsibility for caring for a child, aged person, disabled person or someone with special needs. The research goes on to show that 31% of these found caring information is hard to access in rural areas and 51% are not able to access respite. Importantly only 32% felt that there were adequate services to support mothers. Social conditions affecting health and wellbeing in rural areas are often exacerbated by the stereotypical views of rural people, particularly men. Injury and illness is often managed at home and consultations with medical practitioners are delayed. The statistically later presentation for National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC -9- NRWC– Health and Well Being of Rural Women February 2005 treatment amongst rural dwellers, compared to urban dwellers, often results in poorer outcomes13. Whilst this statistic may be more reflective of rural men, the worry and stress of an untended illness often falls on the female carer. The issue of aged care is a serious one for rural women. Women statistically outlive men making the care of the aged in rural areas, predominantly a gendered issue. Compounding this, older women are one of the most socially and economically vulnerable demographics in Australia today. This is exacerbated in rural and remote areas. This social phenomenon requires specific services to address the needs of this group. The World Health Organisation (WHO) acknowledges the lower income levels, mobility issues and generally poorer health of older (over 70) women. WHO now uses terms such as ‘healthy life expectancy’ rather than life expectancy to reflect the different quality of life experienced by older people suffering poor health. Community services make up the second largest industry group in regional cities with over 21% of the total workforce14. However, the workforce is largely casualised, feminised and still relies heavily on voluntary efforts. The large scale withdrawal of services in regional and rural Australia over recent years has resulted in a clear need for carefully targeted services as well as community development programs. The NRWC believes that this requires a ‘whole of community’ approach through the collaboration of service providers, consumers, government and community. 65% of rural women find it difficult to access medical specialists in their area and 60% find it difficult to access bulk billing in their area. CSU ‘Rural Women’s Indicator Project’ 2004 National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC - 10 - NRWC– Health and Well Being of Rural Women February 2005 5. Maternity Services Whilst access to services in rural areas was an issue across many health concerns, the lack of maternal issues was of particular concern to the rural women we consulted. The CSU research indicates that 51% of rural women report difficulty in accessing maternity services and 58% find it difficult to access birthing centre services. Recent increases in medical indemnity costs has made it increasingly difficult and in many cases impossible for rural GP’s to offer maternity services. Fewer rural GPs are delivering babies and fewer rural GPs are doing antenatal care. Rural health issues significantly impact on ante and post natal care of the mother and baby. These include: • • • • • • • • Higher rate of teenage pregnancies, Poor access to perceived confidential health care, Higher rates of smokers, Lower access to antenatal care, Less antenatal screening, Social isolation, Less access to postnatal home visits by midwives and family services and Less access to postnatal depression services. Adolescent pregnancy is also significant issue in rural areas. This may be due to the lack of contraceptive advice, limited or no abortion services, limited confidentiality from health workers because worker and client know each other in community settings and lack of health workers. High rates of adolescent pregnancies in remote areas are consistent with high rates in socially disadvantaged communities generally 15. The NRWC was pleased to note the high profile activity occurring in the area of rural maternity services through such organisations as the National Rural Health Alliance and the Maternity Coalition. The NRWC is committed to supporting these organisations in promoting the needs of women and babies in rural Australia. The rate of deaths related to complications from pregnancy is 3 – 4 times higher among women who receive no prenatal care compared to women who received prenatal care. National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC - 11 - NRWC– Health and Well Being of Rural Women February 2005 6. Foetal Alcohol Syndrome The seriousness of Foetal Alcohol Syndrome (FAS) was highlighted through a moving presentation at the NRWC Health Forum by Lorian Hayes. Participants at the forum felt strongly that this is a serious issue for Indigenous and non-Indigenous communities. This was felt to be particularly important in rural communities where access to information and counselling is limited. Studies have consistently identified the serous nature of the effects of alcohol on foetal development. These include: intellectual disability, cognitive impairments, learning difficulties, speech and language delay, and behavioural and emotional problems. During pregnancy alcohol is not only carried to all organs and tissues, it has the potential to cross the placental barrier and transfers from mother to foetus. The amniotic fluid is considered a reservoir for ethanol, which increases the availability of the drug to the foetus. When a pregnant woman drinks alcohol the concentration of alcohol in her unborn baby’s bloodstream is the same level as her own. The liver of the developing foetus cannot process the alcohol at the same rate as the adult. High concentrations of alcohol stay in the foetus longer. The unborn baby’s blood alcohol concentration is even higher than that of the mother’s during the second and third hour after a drink is consumed by the mother16. Indigenous women are vulnerable for many reasons particularly when their lives and social interaction are linked with alcohol use. Subsequently it is vital that the relationship between alcohol use and pregnancy is explored from the viewpoint of health; but also the within the boundaries of a socio-cultural context that this relationship plays in women’s lives17. The National Drug Strategy FAS Literature Review acknowledges that FAS has not been the subject of national research or policy development in Australia17. This makes Australia one of the few western countries that have not acted on this serious issue. With one child born in Canada every day with FAS18, it is clear that the Australian government has not done enough to investigate or act on FAS in Australia. Raising the awareness of Foetal Alcohol Syndrome amongst women, community members, and health professionals in the community will make an important contribution to the improvement in health and wellbeing of women and their babies in rural areas. In the USA, Foetal Alcohol Syndrome is recognised as the leading preventable cause of mental retardation. Institute of Medicine 1996 National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC - 12 - NRWC– Health and Well Being of Rural Women February 2005 7. Women affecting change The most powerful outcome of NRWC’s consultations was the overarching theme of the capacity of women to affect change. The themes of women in leadership and the contribution of women to balanced policy development have been consistent recommendations throughout NRWC’s consultations across all projects. The number of women in leadership positions in rural areas is an issue of great concern to rural women. It is felt that leadership opportunities are not as accessible to rural women due to infrastructural and social restrictions such as lack of accessible child care, lack of mentoring or female role models and stereotypical issues in rural Australia. Whilst it is recognised that women are targeted for leadership potential in a variety of rural programs, the rural women we consulted felt that these programs are under communicated. Women who are caring for children or other dependants find it difficult to access these programs. Also, lack of personal confidence, particularly with regard to Information and Communication Technology, is a major barrier to women taking on more decision-making roles in rural areas. Overwhelmingly, rural women want to influence policy that affects their quality of lives. Top heavy, silo-based service delivery models within government have resulted in ‘grass roots’ individuals having very limited access to real policy development. The people whose lives will be most affected by policy initiatives, particularly women, often have the least say in the development and implementation of these policies. Since its inception in 2002, the NRWC has consulted rural women in a strategically developed programme to develop bottom-up policy recommendations. We recognise the enormous value of grass roots input and the positive effect this has on making robust and balanced policy recommendations. Feedback from rural women indicates the enormous value of a national policy advocacy body for rural women, such as the NRWC. The NRWC is able to consult with rural women in a way that makes them feel comfortable and positive. Their contribution is then turned into policy advice provided directly to government. This is a powerful tool in developing health and wellbeing in rural women. The positivity surrounding personal empowerment, mental stimulation and professional satisfaction cannot be underestimated. This has a vital flow-on effect in rural communities that builds capacity and resiliency. “The atmosphere created right from the start made me feel part of the process and part of the solution”. Direct Quote, NRWC Health Forum Participant National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC - 13 - NRWC– Health and Well Being of Rural Women February 2005 8. Family Violence Family Violence in rural Australia has been a topic of concern for the NRWC since its inception in 2002. Consistently, rural women have raised their concern for the higher incidence and seriousness of domestic violence in non-urban areas compared to urban areas. The Womens Services Network Report (WESNET) 2003 states the following: • Compared to women living in metropolitan areas, women in regional, rural and remote areas were less likely to use crisis services or report to police. • Women are subjected to high levels of violence and abuse at the hands of their spouses and other family members in rural and remote areas. • Data shows disproportionately high rates of domestic and family violence in remote areas, which is three times the rate in other geographical areas. Rates in rural areas are also higher than metropolitan rates, as were rates in regional areas. • The highest rate of apprehended violence orders (AVO's) or Intervention Orders (IO’s) are in rural areas. • In 1999, it was found that nationally 61% of women homicide victims were killed as a result of domestic and family violence. This rate is higher in rural and remote areas. • There is a direct link between dominant rural ideologies and community acceptance of domestic violence. The complex interplay of community values and attitudes present in regional, rural and remote areas and its acceptance and condoning of domestic and family violence are directly linked to its increased incidence. Rural women are also concerned with the issue of family violence in Indigenous communities. The physical, psychological and emotional repercussions of family violence are obvious. Healthy relationships and healthy partnerships are pivotal to the health and well being of women in rural, remote and regional Australia. The NRWC has previously identified the benefits of establishing a cross organisational approach to addressing the complexity of family violence in a rural community. However, the three tiers of government in Australia must look seriously at the resources devoted to family violence in rural communities. The provision of services in rural areas must become a priority. Accessible safe houses, financial support and transport are essential to the safety of women and children at risk. Importantly, communities must be supported in a way that suits the local residents and community stakeholders. There are estimates that one third of Aboriginal women in the Northern Territory are assaulted each year. In addition to this, 33% of all reports of violent crimes experienced by indigenous women were family violence, compared to a national average across all cultural groups of 9.5%. WESNET Report 2003 National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC - 14 - NRWC– Health and Well Being of Rural Women February 2005 9. NRWC Position As a result of the NRWC’s consultations, research and national forum, the NRWC Council supports the following positions and undertakes the following actions: The NRWC believes: a. Rural women and families have a democratic entitlement to the same quality, accessibility and affordability of health care as urban women. b. Healthy women create, and contribute to, healthy communities. c. Rural Indigenous women, older rural women and women in remote communities are possibly the most disadvantaged groups in Australia today; in terms of access to appropriate health services. d. That the incorporation of Indigenous knowledge and experiences is essential for future policy development. The NRWC will: a. Investigate the opportunities of a targeted partnership with Lifeline and beyondblue: a national depression initiative to address mental health amongst rural women. b. Establish a cross-organisational working group to support awareness of Foetal Alcohol Syndrome in Australia. c. Work with the National Rural Health alliance and the Maternity Coalition to address maternity services deficiencies in rural Australia. d. Investigate the possibilities of expanding rural leadership opportunities for rural women. e. Advocate the recommendations arising from the NRWC’s Healthy Women – Healthy Communities project to all levels of government. National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC - 15 - NRWC– Health and Well Being of Rural Women February 2005 10. Recommendations The NRWC will advocate the following recommendations to all levels of government. The NRWC recommends: a. The development of a cohesive and comprehensive national mental health strategy for rural Australia. b. Equity of access to health services and information in rural Australia. c. Equity of access and affordability to Information Technology in rural Australia. d. Appropriate funding of health services in rural communities based on a collaborative, community-based, approach to modelling services to meet the needs of individual communities. e. Maintaining and expanding maternity services in rural Australia. f. The development of a national strategy to raise awareness of, and address the consequences of, Foetal Alcohol Syndrome g. Community capacity building solutions in rural communities, including increased housing availability, independent living and appropriate public transport. h. Increased child care in rural communities. i. Targeting rural women for leadership opportunities and involvement in real decision making. j. The ongoing funding and support of a rural women’s peak policy advocacy body. National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC - 16 - NRWC– Health and Well Being of Rural Women February 2005 11. References 1 Beyondblue: a national depression intitiative. Presentation NRWC Healthy Women-Healthy Communities National Forum, October 2004 2 Beyondblue: a national depression intitiative. Presentation NRWC Healthy Women-Healthy Communities National Forum, October 2004. Australian Bureau of Statistics March 2000 3 Dr. L. Walters. Presentation. NRWC Healthy Women-Healthy Communities National Forum, October 2004 4 Quine et al 2003 5 Thurston and Meadows 2003 6 Savage et al 2003 7 Kawachi, Kennedy and Lochner 1997 8 Ryan-Nicholls 2004 9 Warner-Smith & Brown 2002 10 11 Brown, Young and Byles 1997 Young and Dobson 2004 12 SCRGSP 2003 13 Elliot-Schmidt and Strong 1997 14 Beer, A., Bolam, A. & Maude, A. (1994) Beyond the Capitals. Urban Growth in Regiona Australia. Urban Futures Research Programme: Canberra. 15 Thompson 1998 16 Lorian Hayes, NRWC Healthy Women – Healthy Communities October 2004 17 National Drug Strategy 2001- 2003/4 18 Health Canada URL 2002 National Rural Women's Coalition Po Box 178 Deakin West ACT 2600 www.ruralwomen.org.au ABN 74 950 044 044 Report written by: Judy Swann OAM Executive Officer NRWC - 17 -
© Copyright 2024