Discussion Paper for the Development of the National Aboriginal and Torres Strait Islander Health Plan
What is the current state of Aboriginal and Torres Strait Islander peoples’ health?
Up to National Aboriginal and Torres Strait Islander Health Plan
Indigenous Australians currently experience more illness, disability and injury than other Australians. They also die at younger ages compared with non-Indigenous Australians. The graph below shows estimates of life expectancy for Indigenous and non-Indigenous Australians. Indigenous females born between 2005 and 2007 may be expected to live around 9.7 years less than non-Indigenous females born during the same time period. For males this gap is even greater at around 11.5 years.1
Figure 1: Life expectancy estimates for Indigenous and non-Indigenous Australians
The graph below shows the leading causes of death for Aboriginal and Torres Strait Islander people during the period 2006 to 2010. 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, such as heart attack, stroke, cancer, diabetes, respiratory disease and kidney disease. Suicide and transport accidents and other injuries are also leading causes of death.
Figure 2: Leading causes of death for Aboriginal and Torres Strait Islander peoples 2006-2010
Half of the gap in health between Indigenous and non-Indigenous Australians is linked to 11 risk factors such as smoking, obesity and physical inactivity (see graph below).2 Risk factors are also closely linked to social and economic determinants of health. A number of studies have found between one third and one half of the health gap is associated with differences in socioeconomic status such as education, employment and income.3 4
Figure 3: Other risk factors contributing to the health gap between Indigenous and non-Indigenous peoples
We know that there are important stages in all our lives which impact on our health and wellbeing, and that the things that happen in our younger years often have a bearing on our health as we get older. These stages also provide significant and strategic points of intersection between health and mental health and social and emotional wellbeing.
- Pregnancy and babies. There is a significant body of evidence that shows the experience of the child before, during and after birth, and into early childhood has an impact on health throughout life. The health and wellbeing of the mother during and after pregnancy is also important for the child’s immediate and long term outcomes. While the Indigenous infant mortality rate has improved significantly in the last 20 years, there are still a lot of babies born with low birthweight. Low birthweight is linked to smoking during pregnancy and premature births, and is more likely to lead to illnesses throughout childhood and into adulthood, as well as lower achievement and other difficulties in school, and social problems.
- Childhood (0–14 years). Improving the health, social and environmental factors of babies and children will have positive effects throughout life. The early childhood years are the most important in terms of brain development, including the development of cognitive and social skills that form the foundation for future learning and achievement. Improvements include a significant decline in mortality for Indigenous children aged 0-4 years. There are also increasing numbers of Aboriginal and Torres Strait Islander children who are fully immunised, which has helped reduce diseases such as mumps and measles. Areas of concern include chronic ear disease, with Indigenous children 3 times more likely to be diagnosed with ear or hearing problems, which can lead to hearing loss and in turn affect language and social development. Another area of concern is exposure to tobacco smoke, which is a major contributor to poor health outcomes in children. A greater proportion of Aboriginal and Torres Strait Islander children live in households with a regular smoker than non-Indigenous children.
- Youth (15–24 years). Adolescence is a time of great personal change and stress for many young people, with Aboriginal and Torres Strait Islander young people currently experiencing higher rates of poor health and three times as likely to report high levels of psychological distress than non-Indigenous youth. However, this age group also has the best opportunity to set up a healthy adulthood. For example, while young people in this age group are low users of primary health care services, the lifestyle factors that lead to chronic diseases later in life are often established in this age group. This can therefore be a time for families and communities to work with young people on preventative health, including encouraging them to use health services and helping them to develop a positive sense of themselves, which will provide a strong foundation for a healthy and long life.
- Adults. This is the age at which individuals can be expected to take on increasing responsibilities – within families, their communities and in the workforce. However, this is also the age group with the greatest gap between Aboriginal and Torres Strait Islander and non-Indigenous mortality, leading to greater social, emotional and financial pressures on families and communities as a result. Early deaths from chronic diseases, such as heart disease and stroke, cancer, diabetes and respiratory disease are a major concern in this age group. In addition, hospitalisation rates for Indigenous Australians are higher compared to those for non-Indigenous Australians. It is therefore important to maintain a focus on positive health behaviours and address the major threats to the health of Aboriginal and Torres Strait Islander people, such as smoking, poor nutrition and lack of exercise, to reduce the lifestyle-risk factors that contribute to preventable chronic disease.5
- Older adults and elders. Aboriginal and Torres Strait Islander people have identified strong vision and direction from elders, including older role models to listen and advise, as an important factor for positive health and wellbeing. While healthy ageing is important to ensure the vitality and continued contribution of Indigenous elders to their families and communities, Aboriginal and Torres Strait Islander people in this age group are much less likely to report good or excellent health than non-Indigenous Australians the same age. A higher proportion of Aboriginal and Torres Strait Islander peoples in these older age groups have disabilities and need help with daily living. Older Australians who are not as physically or mentally capable as they once were, especially those with health problems, may also need additional support and access to services.Top of Page
1. ABS (2009). Experimental life tables for Aboriginal and Torres Strait Islander Australians, 2005–2007. Cat. no. 3302.0.55.003. Canberra: ABS.
2. Vos, T, Barker, B, Stanley, L & Lopez, AD (2007). The burden of disease and injury in Aboriginal and Torres Strait Islander peoples 2003. Brisbane: School of Population Health, University of Queensland.
3. Booth, A & Carroll, N (2005). The health status of Indigenous and non-Indigenous Australians. Canberra: Centre for Economic Policy Research, ANU,
4. DSI Consulting Pty Ltd and Benham, D (2009) An investigation of the effect of socio-economic factors on the Indigenous life expectancy gap, DSI Consulting Pty Ltd.
5. Australian Government (2012). Closing the Gap: Prime Minister’s Report 2012, Canberra.