Home > For Consumers > Aboriginal and Torres Strait Islander Health > National Aboriginal and Torres Strait Islander Health Plan

National Aboriginal and Torres Strait Islander Health Plan

Discussion paper for the Development of the National Aboriginal and Torres Strait Islander Health Plan

PDF printable version of Executive Summary - Discussion paper for the Development of the National Aboriginal and Torres Strait Islander Health Plan (PDF 958 KB)

Executive Summary

The National Aboriginal and Torres Strait Islander Health Plan will support the Australian Government’s long standing commitment to work with Aboriginal and Torres Strait Islander people to support improvements in health outcomes and other determinants of health.

The Australian Government will be working and consulting with Aboriginal and Torres Strait Islander individuals, communities and groups, health service providers, education providers, employment organisations and State, Territory and Local Governments, to make sure the Health Plan meets the varied needs of all Indigenous Australians.

We welcome Aboriginal and Torres Strait Islander peoples’ thoughts on what is most important for their health and what needs to be done. This paper provides a summary of the Discussion Paper and is intended to be a ‘discussion starter.’ Please refer to the Discussion paper for more information.

What is the current state of Aboriginal and Torres Strait Islander peoples’ health?

Progress is being made towards closing the gap in life expectancy and halving the gap in child mortality. There has been a large reduction in deaths due to circulatory disease and a small but significant decrease in smoking rates. There have also been improvements in children being immunised and a reduction in infant deaths.

However, Aboriginal and Torres Strait Islander people still face a great number of health challenges experiencing more illness, disability and injury than other Australians. Indigenous children born today can expect to live shorter lives than non-Indigenous children – 11.5 years shorter for males, and 9.7 years shorter for females.

Around two-thirds of the gap in health outcomes between Aboriginal and Torres Strait Islander Australians and other Australians is due to long-term health problems.

Figure 1: Leading causes of death for Aboriginal and Torres Strait Islander peoples 2006-2010

Key considerations and opportunities to improve health and wellbeing

Determinants of health

The origins of health behaviours are a complex range of environmental, social, economic, family and community factors. Up to half of the gap may be explained by differences in the social determinants which affect peoples’ health and can influence how a person interacts with health and other services.

In the Aboriginal and Torres Strait Islander context, health is complex and multi-faceted including physical health of individuals, social and emotional health, and the wellbeing of the whole community. Family, culture and community functioning provide a source of strength for health and wellbeing. There is a role for each individual, family and community to take responsibility for rebuilding the social norms that are the foundation for lasting change.

Having an education, a job and an income generally has a positive effect on health and wellbeing. Early childhood is a critical time in human development. Having good outcomes at school supports further education and employment prospects. Higher levels of education are linked to a better understanding of healthy lifestyles and the health care system.

Racism and discrimination are other barriers to accessing health care. Aboriginal and Torres Strait Islander peoples continue to experience racism across multiple settings. Discrimination is linked to poor self-assessed health status, stress-related diseases, psychological distress, diabetes, smoking and substance use, and generally has a negative impact on health.

Opportunities within the health system

While the health system has an important role to play in providing information on healthy lifestyles and treatment of diseases to support people to proactively manage their health, we all have responsibilities to take action to live a healthy life and proactively manage our health.

The cultural competency of health services impacts on how Aboriginal and Torres Strait Islander people make decisions to use health services. Other factors include cost, availability, distance and transport. Building the capacity of the Aboriginal and Torres Strait Islander health workforce is fundamental to enhancing the cultural competency of health services and improving access to health care.

Aboriginal Medical Services, including Aboriginal Community Controlled Health Services, play an important role in providing culturally competent, comprehensive primary health care. Mainstream general practice is also a major source of primary health care. Although Aboriginal and Torres Strait Islander people access primary health care services at a similar rate to other Australians, they are less likely to receive early detection and treatment of disease.

Aboriginal and Torres Strait Islander people are more likely to go to hospital for treatment than other Australians. However, they are less likely to receive a medical procedure or surgery, and are more likely to leave against medical advice. Many hospital admissions could be prevented if more effective prevention or non-hospital care were available or accessible.

There are a range of other services that are important in providing comprehensive health care. For example, specialised services provide care to people with a specific health condition. Allied health care is particularly important for people who have more than one health condition. Dental care helps maintain oral health and prevent potential health problems. Early access to mental health services can help address mental health issues and help restore peoples’ social and emotional wellbeing. There are a range of aged care services available for older people who require long-term support with basic living activities. Challenges remain for improving access to these services for Aboriginal and Torres Strait Islander peoples.

The coordination of services is important for providing comprehensive health care, particularly for patients with complex health needs. Lack of coordinated care may mean that patients miss out on specialised care as they move between health services. The integration of services is also important; for example, managing mental health, social and emotional wellbeing, and substance use together. Improving the coordination and integration of health care and other services remains a challenge.

What should the Health Plan look like? Have your say

A series of nationwide community consultations will be held, as well as an opportunity to provide written submissions, commencing in September 2012. To find out more, or make a submission, please visit the Health Plan webpage.
We would like to hear from you about your views, including what you think the priorities and the principles of the Health Plan should be. You may wish to use some, or all, of the following questions for your response.

Consultation questions

Determinants of health

• How can the Health Plan harness the strengths and culture of Aboriginal and Torres Strait Islander peoples to improve the health of Aboriginal and Torres Strait Islander peoples?
• What are the key things that would make a difference to Aboriginal and Torres Strait Islander peoples health outcomes?
• What do governments need to do to:
  • Build on the strengths of Aboriginal & Torres Strait Islander peoples to improve their health?
  • Support Aboriginal and Torres Strait Islander peoples to proactively manage their health and to achieve and maintain social, emotional and cultural wellbeing?
  • Address the social determinants of health?

Health system

• How could the health system work better for Aboriginal and Torres Strait Islander peoples? This may include: health promotion activities, comprehensive primary health care, allied health and specialist services, mental health services, hospitals and aged care?
• What more could be done to facilitate the growth, support and retention of Aboriginal and Torres Strait Islander health professionals?
• What more could be done to develop, support and retain mainstream health professionals to provide comprehensive and culturally appropriate health care services to Aboriginal peoples?
• How could the integration and coordination of comprehensive health care for Aboriginal and Torres Strait Islander patients be improved? Examples include:
  • support for patients after they have been discharged from hospital?
  • the interaction between mental health and drug and alcohol services?
• How can comprehensive health care services be made more accessible for Aboriginal and Torres Strait Islander peoples, including in urban, regional and remote areas?
• How can services be made more culturally competent and appropriate for Aboriginal and Torres Strait Islander peoples?

Principles and priorities

• What do you think should be the guiding principles of the Health Plan?
• What do you think should be the priorities for the Health Plan?

Is there anything else you would like to tell us that would help in the development of the Health Plan?