Online version of the 2012-13 Department of Health and Ageing Annual Report

3.8: Strategic Change Indicators of Social Inclusion

Page last updated: 29 October 2013

We recognise and tackle the cause and impacts of health inequities through innovative, evidence based collaborative practices


Since 2011, Australian Government departments have been held accountable for their progress on social inclusion through reporting on strategic change indicators of social inclusion relevant to their portfolio in their annual reports. Strategic change indicators are short-term progress measures of potential progress in relevant areas of government policy and service delivery.

The Department reports against seven strategic change indicators on health risk factors for social inclusion and the outputs of government health and ageing programs designed to improve inclusion outcomes.

The indicators are reported by socio-economic status using Socio-Economic Indexes for Areas (SEIFA) and remoteness, subject to data availability. Not all data for the social change indicators can be expressed in the same categories.


Mortality rate

Mortality rate is a summary measure of the overall health status of a population. Improvements rely not just on access to health services but on a range of factors including living conditions, and economic and social circumstances. This indicator will measure progress towards the Council of Australian Governments (COAG) target to close the life expectancy gap between Indigenous and non-Indigenous Australians within a generation.

Mortality rate (by Indigenous status) 2007-11 (aged standardised rate per 100,000 population)98
Non-Indigenous Australians 596
Indigenous Australians 1,151

Notes: Rates are directly age-standardised using the 2001 Australian Estimated Resident population.
SEIFA and remoteness data not available.

Child mortality rate

The child (0-4 years) mortality rate is an important indicator of the health of pregnant women, newborns and children. Halving the gap in mortality rates for Indigenous children under five within a decade (that is, by 2018) is one of the COAG targets to reduce disadvantage among Indigenous Australians. Indigenous child mortality rates are currently within the range required to meet the target.

Child (0-4) years mortality rate (by Indigenous status), 2007-11 (rate per 100,000 population)99
Non-Indigenous Australians 95
Indigenous Australians 212

Note: SEIFA and remoteness data not available.


Obesity is a major risk factor for multiple chronic diseases which in turn are major causes of disability. There is a clear socio-economic gradient in obesity and its causes are exacerbated by social disadvantage and remoteness.

Obesity rate (by Indigenous status, SEIFA and remoteness), Australia, 2011-12100
All Australians Total Rate 27.5%
Indigenous Australians Total Rate Data not yet available101
Index of Disadvantage Quintile 1
(Most Disadvantaged)
32.8% Quintile 5
(Least Disadvantaged)
Remoteness of Residence Major Cities 25.5% Remote 33.9%

Note: Data for adults (18 years and over) and is not age standardised.


Smoking is a major risk factor for multiple chronic diseases and is thus a major cause of disability and death. There is a clear socio-economic gradient in smoking prevalence and, its causes are exacerbated by social disadvantage and remoteness.

Daily smoking rate (by Indigenous status, SEIFA and remoteness), Australia, 2011-12102
All Australians Total Rate 16.1%
Indigenous Australians Total Rate Data not yet available103
Index of Disadvantage Quintile 1
(Most Disadvantaged)
23.0% Quintile 5
(Least Disadvantaged)
Remoteness of Residence Major Cities 14.7% Outer Regional and Remote 22.4%

Notes: Data for all Australians, index of disadvantage and remoteness of residence categories is for adults (18 years and over) and is not age standardised. The age standardised rate for all Australian adults (18 years and over) is 16.3%.
Very remote category has not been reported separately.

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People deferring recommended treatment

Deferring recommended treatment increases the chances that a medical condition will deteriorate. Social disadvantage contributes to treatment deferral, particularly in relation to purchasing medications.

Proportion of people deferring recommended treatment due to financial barriers (by SIEFA) 2011-12104
Financial Barriers to use of service
General Practitioners 8.7% Lowest Decile 7.5% Highest Decile 5.6%
Specialists 9.4% Lowest Decile 8.9% Highest Decile 7.1%
Medications 9.6% Lowest Decile 11.0% Highest Decile 7.0%

Notes: Data are not available for Indigenous Australians.
Very remote data were not collected in the 2010-11 Patient Experience Survey.
Data are for persons aged 15 years and over, and age standardised to the 2001 Estimated Resident Population.

Potentially preventable hospitalisations

Preventable hospitalisations can indicate that illness and treatment are poorly controlled and therefore more likely to impact on a person’s ability to participate in work and social life. Social disadvantage and remoteness are strongly associated with avoidable hospitalisations.

Rate of selected potentially preventable hospitalisations, by Indigenous status, remoteness and SEIFA, Australia, 2010-11 (aged standardised rate per 100,000 population)105
Indigenous Australians Total 11,137.8
Other Australians Total 2,672.2
Index of Disadvantage Quintile 1 3,432.2 Quintile 5 2,111.3
(Most Disadvantaged) (Least Disadvantaged)
Remoteness of Residence Major Cities 2,600.2 Very Remote 6,430.2

Treatment rates for mental illness

Increasing numbers of people have received treatment for mental illness. This may indicate improved access to services and better-targeted services, or higher rates of mental illness. However, the 2011-12 Budget initiatives, which span five years, aim to build the capacity of the mental health care system so that Australians with, or at risk of mental illness receive treatment. Improving mental health contributes towards engaging socially and participating in work.

Treatment rates for mental illness (Commonwealth funded Medicare and DVA services)106
Proportion of people receiving clinical mental health services 2010-11
Aged standardised rate Public 1.6% Private 0.1%
Type of Service
Psychiatrist 1.4%
Clinical Psychologist 1.1%
General Practitioner 5.4%
Other Allied Health 2.2%
Total 6.9%


Department of the Prime Minister and Cabinet 2010, A Stronger, Fairer Australia: National Statement on Social Inclusion.

COAG Reform Council (2013), Healthcare 2011-12: Comparing performance across Australia, Statistical supplement, COAG Reform Council, Sydney, 30 April 2013.

COAG Reform Council (2013), Indigenous Reform 2011-12: Comparing performance across Australia Sydney, 30 April 2013.

ABS Datacube: 48390DO001_201112 Patient Experiences in Australia: Summary of Findings, 2011-12.

ABS Table 3: 43640DO003_20112012 Australian Health Survey: Updated Results, 2011–12 - Australia, released 7 June 2013.

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