Aboriginal and Torres Strait Islander Health Performance Framework - 2010
Tier 2: Determinants of Health
Table of contents
- Executive Summary
- Acknowledgements
- Abbreviations
- Introduction
- Key Messages
- National Health Policies and Strategies
Tier 1: Health Status and Outcomes
Tier 2: Determinants of Health- 2.01 Access to functional housing with utilities
- 2.02 Overcrowding in housing
- 2.03 Environmental tobacco smoke
- 2.04 Years 3, 5 and 7 literacy and numeracy
- 2.05 Years 10 and 12 retention and attainment
- 2.06 Educational participation and attainment of Aboriginal and Torres Strait Islander adults
- 2.07 Employment status
- 2.08 Income
- 2.09 Housing tenure type
- 2.10 Index of disadvantage
- 2.11 Dependency ratio
- 2.12 Single-parent families
- 2.13 Community safety
- 2.14 Contact with the criminal justice system
- 2.15 Child protection
- 2.16 Transport
- 2.17 Indigenous people with access to their traditional lands
- 2.18 Tobacco use
- 2.19 Tobacco smoking during pregnancy
- 2.20 Risky and high risk alcohol consumption
- 2.21 Drug and other substance use including inhalants
- 2.22 Level of physical activity
- 2.23 Dietary behaviours
- 2.24 Breastfeeding practices
- 2.25 Unsafe sexual practices
- 2.26 Prevalence of overweight and obesity
- Tier 3: Health System Performance
- References
- Technical Appendix
Environmental Factors
2.01 Access to functional housing with utilities2.02 Overcrowding in housing
2.03 Environmental tobacco smoke
Socio-Economic Factors
2.04 Years 3, 5 and 7 literacy and numeracy2.05 Years 10 and 12 retention and attainment
2.06 Educational participation and attainment of Aboriginal and Torres Strait Islander adults
2.07 Employment status
2.08 Income
2.09 Housing tenure type
2.10 Index of disadvantage
Community Capacity
2.11 Dependency ratio2.12 Single-parent families
2.13 Community safety
2.14 Contact with the criminal justice system
2.15 Child protection
2.16 Transport
2.17 Indigenous people with access to their traditional lands
Health Behaviours
2.18 Tobacco use2.19 Tobacco smoking during pregnancy
2.20 Risky and high risk alcohol consumption
2.21 Drug and other substance use including inhalants
2.22 Level of physical activity
2.23 Dietary behaviours
2.24 Breastfeeding practices
2.25 Unsafe sexual practices
Person-Related Factors
2.26 Prevalence of overweight and obesityTier 2, Determinants of Health, includes measures that convey the impact on health from environmental and socioeconomic factors, community capacity, health behaviours and person-related factors. Many of these issues do not relate directly to the activities of the health system, but they impact on health outcomes and how people access health care. Reliable information on the size and distribution of determinants of health in the Aboriginal and Torres Strait Islander population, and comparisons with the non-Indigenous population is crucial for evaluating the effects of current health and social policies; developing and prioritising strategies for health gain; highlighting areas for intersectoral action; and to support identification of research priorities. The determinants of health are now widely recognised as an essential element of health system analysis (WHO Commission on Social Determinants of Health 2008).
Measures in Tier 2 underpin health outcomes and shape how patients interact with the health system. For example, analysis has confirmed that lower levels of education, a key measure of socioeconomic status, is associated with a higher prevalence of health risk factors such as smoking and obesity (see discussion in key findings). Similarly, health status impacts on its determinants: improvements in education outcomes can be anticipated with improvements in health (see measure 1.12 Children’s hearing loss for an example of this connection).
Readers are encouraged to consider health determinants as both risk and protective factors. Improvements made in health behaviours, such as reduced smoking rates or educational attainment will flow on to improvements in how people utilise the health system and to improvements in health outcomes. Many of the measures in Tier 2, particularly those determinants grouped as ‘community capacity’ relate to the measure of ‘Community functioning’ (measure 1.14) in Tier 1. This measure illustrates the positives of health determinants, health behaviours and use of the health system in a combined analysis of strengths and capabilities using values determined by Aboriginal and Torres Strait Islander peoples.