Over recent decades, Australia has become more unequal in terms of income, wealth, employment, and health. We analysed publicly available Australian data and found that the social gradient in health, income, wealth and labour force participation have all steepened. This makes calls for comprehensive primary health care even more urgent as one strategy to address underlying structural factors driving these worsening inequities.

The Closing the Gap policy framework has made little impact in addressing Aboriginal health disparities. However, Aboriginal Elders are quietly leading the way in community healing; represented by a suite of therapeutic practices and the promotion of cultural values to strengthen Aboriginal identity, community cohesion and connections to Country. Elders provide stakeholders with a culturally embedded framework to advance the health and well-being of Aboriginal people.

Limited access to free, clean and refreshing tap water can increase reliance on sugar-sweetened beverages. This study found that access to clean, refrigerated and filtered drinking water is more likely in larger communities with a lower proportion of Aboriginal people, indicating that Aboriginal people living in smaller communities have their socioeconomic disadvantage compounded, potentially increasing reliance on sugar-sweetened beverages and widening the health gap between Aboriginal and non-Aboriginal people. Health promotion initiatives must take into consideration access to clean and refreshing tap water.

Patient activation and health literacy are essential drivers for self-management activities. However, there is a lack of evidence regarding the effectiveness of using chronic diseases self-management interventions targeting both factors. This systematic review found that patient activation- and health literacy-targeted interventions led to significant improvements in mental health status and physical activity level, but did not improve quality of life and health care utilisation. Strong associations between patient activation and health literacy levels were revealed.

Primary care professionals often report barriers to initiating advance care planning (ACP) and palliative care (PC), affecting patients’ end-of-life care experiences. This paper provides evidence to suggest that nurses working in general practice can be trained and are willing to initiate ACP and PC. By understanding barriers and facilitators to early implementation of the Advance Project model through a theoretical lens, changes were identified that could lead to successful implementation of ACP/PC assessment tools in general practice settings.

Approximately half of all type 1 diabetes (T1D) diagnoses occur in adulthood, yet scarce attention has been paid to adult-onset T1D in academic literature. Evidence suggests that adults with T1D may experience poorer long-term physical and mental health outcomes. The aim of this study was to examine the experiences of individuals living with adult-onset T1D, with particular focus on their diagnosis experience, access to healthcare, and post-diagnostic wellbeing.

The COVID-19 pandemic poses an additional threat to mental health for healthcare workers. We identified unique workplace challenges and stressors faced by GPs that were different from hospital medical staff. Significantly more GPs reported burnout, and experienced moderate-to-severe emotional exhaustion than hospital medical staff. Targeted workplace and psychological support is essential to protect wellbeing among the primary care workforce.

‘Community health’ is an important element of Australian health systems and recognised as such in national policy. Interviews with 13 key informants in roles with responsibility for primary and community health services from health departments in Australian states/ territories found little uniformity in the way community health was described. Inconsistencies in the use of the term ‘community health’ and the complexity of the multi-jurisdictional context need to be acknowledged when considering the design and implementation of national health system programs and reforms.

This study provides a greater understanding for researchers and PHN decision-makers of the key features of PHN community-based pain programs, their alignment with expert-agreed key elements and implementation enablers, target-population gaps, and the types of program adaptations during the COVID-19 pandemic.

The COVID-19 pandemic has facilitated increased accessibility to telehealth in primary care. A survey of 499 consumers revealed a high perception of quality of care and cost savings from the consumer perspective. Key drivers for use of telehealth were reduced travel time and avoiding exposure to COVID-19. Our results suggest that consumers would welcome telehealth as a permanent feature of the primary care system.

Cultural competency is often promoted as a strategy to address health inequities, although evidence linking cultural competency to patient outcomes is scarce. We conducted a narrative review of the recent literature on cultural education programs and found 13 published evaluations, mainly reporting improvements in health professionals’ attitudes and knowledge, and improved confidence in working with First Nations patients. Although cultural education has a positive short-term impact, none of the studies included measured improved patient health outcomes.

People with multicultural or refugee backgrounds are more likely to have poorer long-term health outcomes compared to natively born people, and experience barriers accessing health care. We piloted a multicultural healthcare coordinator service and demonstrated that it was acceptable to patients and primary healthcare practitioners, well-utilised and demonstrated good outcomes. The service has the potential to reduce healthcare inequities if implemented into ongoing primary care services.

Diabetes is a complex condition that substantially impacts quality of life and disproportionately affects Aboriginal Australians. This qualitative study identified that patient-reported outcome measures do not adequately capture the health-related quality of life of Aboriginal adults in the Shoalhaven. Development of culturally tailored health outcome measure tools, resources or methods is feasible if Aboriginal community and researcher-led approaches are prioritised.

Providing an equity lens to measure cultural approaches used in smoking cessation interventions is important. Despite this, there is a research gap between how to provide culturally appropriate support for Aboriginal and Torres Strait Islander pregnant women that meets their needs, is accessible and evidence-based in Australia. We advocate the ongoing use of the ‘Cultural Identity Intervention Systematic Review’ Proforma tool within Aboriginal and Torres Strait Islander health interventions to assess scientific rigour and ethical standards associated with Aboriginal and Torres Strait Islander health research principles and values.

Being physically active and socially connected is predictive of healthy aging; however, COVID-19 has resulted in increased barriers for some older people to engage in these activities. This qualitative research explores the lived experience of participants of the Connect 60+ wellness program, showing how it created a positive environment within the local neighbourhood by having welcoming facilitators, a variety of activities and opportunities for social connection. Community hubs can provide opportunities for older people to engage in healthy aging programs.

Equitable access to gender-affirming hormone treatment (GAHT) for trans and gender-diverse people is universally poor, with most services located in highly medicalised, culturally unsafe environments. Normalising GAHT by locating services within culturally safe mainstream primary healthcare services increases engagement for the trans and gender-diverse community. This project identifies the impact of a trans and gender-diverse co-designed and led GAHT service on client engagement and satisfaction.

This paper examines the implications of the second sentence in Tudor Harts statement about inverse care – that its operation was strongest when exposed to market forces. Examples of inverse care can be found in the disparities access to primary health care in Australia, which can be attributed to both supply-and-demand factors in Australia’s hybrid market model of health care. Correcting these requires changes to the funding and workforce models, as well as specific actions at the service and community level.

Access to publicly funded abortion in Australia is limited, and there are no nationally reported data on service availability. Despite few remaining legal restrictions to abortion, this study found that many regions across Australia either do not have public abortion services or do not provide information about them. There is an urgent need for transparency around public abortion and commitment from State and Federal governments to expand the availability of accessible, no-cost abortion in Australia.

Future Health Today is a new platform, co-designed by general practice for general practice, which aims to streamline the identification and management of chronic disease to improve health outcomes. This paper describes the development of the technology platform and how it was optimised through an implementation study in general practice.

Pharmacists provide essential services to the public and are one of the most accessible health professionals in Australia. Female pharmacists and newly graduates are likely to report low perceptions of psychological safety. Pharmacists with lower reported occupational self-efficacy and higher emotional labour were more likely to report lower levels of wellbeing. Professional organisations, such as the Pharmacy Guild of Australia, play an important role in developing human resource management policies for providing targeted professional support to pharmacists.