Aboriginal and Torres Strait Islander Health Performance Framework - 2010
Why is it important?:Aboriginal and Torres Strait Islander peoples have historically experienced higher rates of arrest and incarceration than other sections of the population (Royal Commission into Aboriginal Deaths in Custody 1991). Prisons have a significant over-representation of people with mental health problems, substance abuse problems, learning difficulties and a history of physical and sexual abuse (Butler & Milner 2003; Levy 2005). Among both Indigenous and non-Indigenous prisoners, rates of chronic conditions such as asthma, cardiovascular disease, diabetes, mental health conditions and communicable diseases are higher than in the general population. Indigenous prisoners have higher levels of diabetes and communicable diseases than their non-Indigenous counterparts, but report lower levels of mental health issues and are less likely to take a prescribed medication (AIHW 2010). Indigenous prisoners suffer greater rates of ill-health and injury compared with the Indigenous population generally (Hobbs et al. 2006). Hospital admissions for mental disorders and injury and poisoning were approximately twice as high among Aboriginal and Torres Strait Islander male prisoners, and 3 times as high for female prisoners.
The effects of prison custody persist after release. A study in Western Australia (Stewart et al. 2004) found that released prisoners have an increased risk of death compared with the general population, and this risk is greater for Aboriginal people, with female Aboriginal prisoners at particularly high relative risk.
The social and health effects of imprisonment on Indigenous peoples include: mental and other health problems for children who have a parent in prison custody—20% of Indigenous children have a parent in custody at some stage (Levy 2005); adverse employment and financial consequences (Woodward 2003); lack of positive male role-models in Indigenous society (Woodward 2003); and prisoners taking health problems and problematic behaviours out into the community (Butler et al. 1997; Butler & Milner 2003; Woodward 2003; van der Poorten et al. 2008). Stressors related to having a family member or friend incarcerated, are reported in measure 2.13.
Findings:As at 30 June 2009, there were 7,386 Aboriginal and Torres Strait Islander prisoners recorded in the National Prison Census. This was an 11% increase in numbers since June 2007—a trend that has continued since the last version of this report. Indigenous prisoners represent 26% of the total prisoner population, up from 24% in 2007. After adjusting for differences in age structure, Indigenous persons were 14 times as likely as non-Indigenous persons to be in prison at 30 June 2009.
In 2009, the median age of Indigenous prisoners was 31 years compared with 35 years for non-Indigenous prisoners. Ninety-two per cent of Indigenous prisoners were male. Indigenous women were also overrepresented in the prison population (29% of women prisoners).
The highest rates of Indigenous imprisonment were reported in Western Australia, New South Wales and South Australia. After adjusting for differences in the age structure between the two populations, Indigenous Australians are 20 times as likely to be imprisoned in Western Australia compared with non-Indigenous Australians, 16 times as likely in South Australia and 13 times as likely in New South Wales.
The median sentence length for Indigenous sentenced prisoners as at 30 June 2009 was 24 months—the same as in 2005—but less than the 42-month median length of sentence of non-Indigenous persons in prison.
Aboriginal and Torres Strait Islander people are more likely to be in prison with a charge related to acts intended to cause injury (32%) than other prisoners (15%). They are less likely to be in prison for illicit drug offences (2%) compared with other prisoners (14%) and homicide (6%) compared with other prisioners (10%).
Aboriginal and Torres Strait Islander people are also over-represented in police custody.
Over the longer term, rates of deaths in custody have been declining for both Indigenous and non-Indigenous people. In 2008 there were 1.34 deaths per 1,000 Indigenous Australians in custody compared with 2.67 per 1,000 in 1998. However, these need to be considered in the context of very high rates of custody. Data from 2008 indicate that there were 13 deaths of Aboriginal and Torres Strait Islander people in custody. Four deaths occurred in police custody and 9 in prison.
In 2007–08, an average of 182 Indigenous youth aged 10–18 years were on remand each day, compared with 134 non-Indigenous youth. On average there were 46 children aged 10–13 years on remand, and 72% of these were Indigenous. Research has found that significant proportions of young Aboriginal people in juvenile justice have a history of a parent in prison (Krieg 2006).
The Health of Australia’s Prisoners, 2009 (AIHW 2010) reported against the first set of national indicators for prisoners’ health in Australia. In 2009, this cross-sectional survey found that 43% of Indigenous prison entrants tested positive for hepatitis C antibody compared with 33% for non-Indigenous entrants and 42% of Indigenous prisoners tested positive for hepatitis B core antibody compared with 17% of non-Indigenous
prisoners. The prevalence of diabetes among Indigenous prison entrants was 5% compared with 3% for non-Indigenous prisoners. The prevalence of asthma and cardiovascular diseases was similar for both groups. Self-reported consumption of alcohol at risky levels in the last 12 months was higher for Indigenous entrants (65% compared with 47%). Consultation rates with a medical professional in the community in the last 12 months were lower for Indigenous prison entrants (62%) compared with non-Indigenous prison entrants (76%). However, consultation rates with a medical professional in prison in the 12 months were higher for Indigenous prisoners (38%) than non-Indigenous prisoners (26%).
Implications:Incarceration of persons whose behaviour is dangerous or disruptive may be beneficial to the community from which they have been removed. However, the high rate of imprisonment of Aboriginal and Torres Strait Islander people signals problems well
beyond those which prisons are designed to resolve. Consultations for this report identified issues such as levels of self-esteem, opportunities for employment, substance abuse and availability of mental health services as factors behind the high rates of incarceration of Aboriginal and Torres Strait Islander peoples. These issues highlight important overlaps between health and other aspects of life such as those highlighted in the Cultural Respect Framework (SCATSIH 2004) and reemphasises the need for inter-sectoral responses.
Incarceration and release makes continuity of care difficult, e.g. for coordination of hepatitis C treatment (Krieg 2006). Some Aboriginal health organisations have developed their own health programs for prisoners and their families (Commission on Social Determinants of Health 2007; Winnunga Nimmityjah Aboriginal Health Service 2007). There are few programs nationally aimed at helping former prisoners make the transition to life outside prison (Borzycki & Baldry 2003).
The Australian Government provides funding through the Indigenous Justice Program to help respond to the urgent challenge of the accelerating rate of Indigenous offending and incarceration, and to support the realisation of safer communities (see measure 2.13). The
program complements other Indigenous law and justice programs such as the Indigenous Legal Aid and Policy Reform Program and the Family Violence Prevention Legal Services Program. Ongoing assessment of the effectiveness of these programs is vital, particularly
given the continued and dramatic increases in the numbers of Indigenous Australians in custody.
Table 49 – People in Prison Custody by Indigenous status, sex and state/territory 30 June 2009
Age standardised rate (b)
Age standardised rate (b)
(b) Number per 100,000 adult population directly age-standardised to 2001 Australian standard population
Source: Source: ABS 2009b
Figure 105 – Age-standardised rate of persons in prison, by Indigenous status 2000 to 2009
Source: ABS 2009b
Text description of figure 105 (TXT 1KB)
Figure 106 – Crude rate of deaths of Aboriginal and Torres Strait Islander persons in prison custody, 1998 to 2008
Source: AIHW analysis of AIC Deaths in Custody in Australia data
Text description of figure 106 (TXT 1KB)