Aboriginal and Torres Strait Islander Health Performance Framework - 2010
Why is it important?:The mortality rate of a population provides a summary measure of the overall health status of that population. However, it has some well-known limitations. There may be delays for many years before improvements in health status lead to reductions in mortality, and mortality statistics do not reflect the burden of illness in a population for diseases that do not necessarily result in death, such as arthritis and depression.
Despite these limitations, mortality rates are a useful measure with which to compare the overall health status of different populations and to monitor changes in overall health status of populations over time.
The all-causes mortality rate for Aboriginal and Torres Strait Islander peoples is several times higher than that for other Australians, indicating that the overall health status of Aboriginal and Torres Strait Islander peoples is worse than that of other Australians.
Findings:During the period 2004–08, 10,840 deaths were identified as those of Aboriginal and Torres Strait Islander people in those jurisdictions with adequate quality data (NSW, Qld, WA, SA, and the NT). After adjusting for age differences between the two populations, the all-cause mortality rate was almost 2 times higher for Aboriginal and Torres Strait Islander peoples than for non-Indigenous Australians (12 vs 6 deaths per 1,000 population).
There has been a 25% reduction in all-causes mortality rates for Indigenous Australians between 1991 and 2008 in jurisdictions with adequate data quality for long-term trends (WA, SA and the NT). The decrease was greater for females (27%) than males (23%). There has been a statistically significant closing of the gap in mortality rates between Indigenous Australians and other Australians over this period.
Current trends (2001–08), in the five jurisdictions, show a slowing in this decline. There has been a non-significant increase in Indigenous mortality rates, and for women, a significant increase in the gap. Note the national results have been affected by a sudden increase of 103 Indigenous deaths in WA between 2007 and 2008. 2009 data which has not yet been included in this analysis shows a decline of 161 Indigenous deaths in WA since 2008.
Most deaths for Aboriginal and Torres Strait Islander peoples occur in the middle age groups. Most deaths for the non-Indigenous population occur in the older age groups. Approximately 66% of Indigenous deaths occur before the age of 65. The greatest relative disadvantage in mortality rates is in the 25–54 years age range, where the mortality rates for Aboriginal and Torres Strait Islander peoples were between 4 and 5 times as high as for other Australians, for both males and females. In the period 2004–08, mortality rates ranged from 9 deaths per 1,000 in New South Wales to 17 in Western Australia.
Mortality rates are also available for other countries where Indigenous peoples share a similar history of relatively recent European colonisation, such as New Zealand and the United States. For the period 2004–08 in New Zealand, the age-standardised all-cause mortality rate for the Maori population was 7 per 1,000, compared with 4 per 1,000 for the non-Indigenous population (Statistics New Zealand unpublished data). For the period 2002–06 in the United States, the age-standardised all-cause mortality rate for American Indians/Alaskan Natives was 5 per 1,000, which was lower than the age-standardised all-cause mortality rate for non-Indigenous persons over this period (6 per 1,000) (United States Department of Health and Human Services unpublished data). Caution must be used in comparing data with other countries due to variations in data quality, methods applied for addressing data quality issues and definitions for identifying Indigenous peoples.
Implications:The very high mortality rates for Aboriginal and Torres Strait Islander peoples, particularly in early childhood and the middle adult years, are an indication of the poor overall health status of Aboriginal and Torres Strait Islander peoples and the high rate of chronic disease and injury.
There has been improvement in mortality rates for Aboriginal and Torres Strait Islander peoples in the past 17 years in WA, SA and the NT, although this has slowed and possibly reversed in the last few years. While the reduction in mortality for Aboriginal and Torres Strait Islander peoples has not kept pace with that for other Australians, the fact that improvements have occurred demonstrates that the severe health problems of Aboriginal and Torres Strait Islander peoples have been reduced to some extent and can be reduced further, and faster, with sustained and increased effort.
In December 2007, COAG agreed to a partnership between all levels of government to work with Indigenous communities to achieve the target of closing the gap in Indigenous disadvantage. To achieve this, COAG committed to six ambitious targets across a range of priority areas, one of which is to ‘close the gap in life expectancy within a generation.’
The National Indigenous Reform Agreement (NIRA) provides the overarching framework for working towards the six targets. The NIRA provides links to relevant National Agreements and Partnership Agreements established to address Indigenous disadvantage across various social, economic and environmental dimensions. Through the COAG, all Governments have agreed to contribute to the $1.6 billion National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. The Commonwealth Government is contributing $805.5 million and states and territories are collectively contributing up to $771.5 (over 4 years) from 2009–10 with a focus on decreasing chronic disease mortality rates.
Figure 59 – Age-standardised mortality rates by Indigenous status, WA, SA and NT, 1991–2008, NSW, Qld, WA, SA and NT, 2001–2008
Source: ABS and AIHW analysis of ABS Mortality Database
Text description of figure 59 (TXT 1KB)
Table 32 – All-causes mortality, by Indigenous status, NSW, Qld, WA, SA and NT, 2004–2008
Number of deaths
Rate per 1,000
|Total NSW, Qld, WA, SA & NT||10,840||467,252|
Figure 60 –Age-specific mortality rates per 100,000 and rate ratios, by Indigenous status and sex, NSW, Qld, WA, SA and NT, 2004–2008
Source: ABS and AIHW analysis of ABS Mortality Database
Text description of figure 60 (TXT 1KB)
Figure 61 – Age distribution of percentage of deaths by sex and Indigenous status, NSW, Qld, WA, SA and NT, 2004–2008
Source: AIHW and ABS analysis of National Mortality Database
Text description of figure 61 (TXT 1KB)