Aboriginal and Torres Strait Islander Health Performance Framework (HPF) 2012

Executive summary—Tier 1: Health Status and Outcomes

The HPF was designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) and will be an important tool for developing the new National Aboriginal and Torres Strait Islander Health Plan (NATSIHP).

Page last updated: 15 November 2012

Improvements

Mortality

  • Analysis of mortality rates between 1991 and 2010 show a significant decline in the Aboriginal and Torres Strait Islander mortality rate (33%) for people living in WA, SA and the NT combined, and a significant narrowing of the gap with non-Indigenous Australians in both absolute (35%) and relative (8%) terms. Changes in the methods and quality of Indigenous identification in deaths data and population estimates have affected this trend.

Avoidable mortality

  • This analysis also finds a significant decline in Indigenous deaths due to avoidable causes in WA, SA and the NT combined, down 24% between 1997 and 2010, and a narrowing of the gap. A detailed study of avoidable mortality in the NT found major declines in conditions amenable to medical care, but only marginal change for potentially preventable conditions e.g., smoking related (Li et al. 2009a).

Circulatory disease

  • Deaths caused by circulatory disease—the most common cause of death for Indigenous Australians—declined by 41% between 1997 and 2010. This rate of decline was faster than for non-Indigenous Australians and the gap narrowed. A study of acute myocardial infarction in the NT between 1992 and 2004 found an improvement in survival for Aboriginal people both pre-hospital and after hospital admission, despite an increase in incidence over this period (You et al. 2009).

Respiratory disease

  • Respiratory disease deaths decreased significantly from 1997 to 2010 and the gap has also narrowed.

Infant and child mortality

  • Analysis of infant mortality rates between 1991 and 2010 show a 62% decline for Aboriginal and Torres Strait Islander infants and a significant narrowing of the gap in both absolute (67%) and relative (35%) terms. There was also a significant decline in the mortality rate for Indigenous children aged 0–4 years and a narrowing of the gap.

Continuing concern

Chronic disease contributes to two-thirds of the health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

  • The majority (68%) of deaths in 2006–10 were due to chronic diseases (e.g., circulatory disease, cancer, diabetes, respiratory disease, kidney disease, etc.).
  • During 2006–10 the leading causes of death were circulatory disease (26%); neoplasms (including cancer) (19%); external causes (including suicide and transport accidents) (15%); endocrine, metabolic and nutritional disorders (including diabetes) (9%); and respiratory diseases (8%).
  • Deaths from circulatory disease have decreased significantly in both the short-term and long-term and the gap has narrowed. However, in 2006–10 Aboriginal and Torres Strait Islander rates were still 1.7 times the rate for non-Indigenous Australians.
  • There has been no improvement in the mortality rate due to diabetes.Top of page

Cancer

  • The gap between the two populations for deaths due to cancer is widening. There has been a significant improvement in cancer death rates for other Australians and no significant change for Indigenous Australians. Research has found disparities in stage of diagnosis and treatment (including lower rates of surgery, chemotherapy and radiotherapy) and lower survival rates for Indigenous Australians.

Kidney disease

  • Aboriginal and Torres Strait Islander mortality rates for kidney disease increased by 89% between 2001 and 2010 (NSW, Qld, WA, SA and the NT combined). This increase was at a faster rate than for non-Indigenous Australians and the gap has widened.
  • The incidence of Indigenous Australians with end stage renal disease commencing renal replacement therapy has increased by more than 96% since 1991, and is 7 times the rate for other Australians.

Injury

  • External causes such as suicide and transport accidents accounted for 15% of Indigenous deaths in 2006–10. Indigenous Australians died from suicide and transport accidents at two and three times the rate of non-Indigenous Australians respectively.
  • There has been no improvement over time in death rates due to external causes.
  • Hospitalisation rates for injury and poisoning are twice as high for Indigenous Australians as the corresponding rates for non-Indigenous Australians.

Disability

  • Half of Indigenous Australians aged 15 years and over had a disability or long-term health condition in 2008. Approximately 8% had a profound or severe core activity limitation. Indigenous Australians aged 15 years and over were 1.4 times as likely as non-Indigenous Australians to have a disability or long term health condition (non-remote areas).

Low birthweight

  • For babies born to Aboriginal and Torres Strait Islander mothers, the low birthweight rate increased by 11% between 1991 and 2009 and the gap widened. However, more recent trends in low birthweight from 2000 to 2009 have found a significant decline for both singleton births (7%) and total Indigenous births (6%). Analysis of these data has found a strong relationship between smoking during pregnancy and low birthweight. There was no relationship found between teenage births and low birthweight for Indigenous mothers.

Eye health

  • In 2008, approximately 9% of Indigenous adults had low vision and 2% were blind. Of those adults with vision impairment, the most common causes were refractive error (54%), cataract (27%), diabetic retinopathy (12%) and trachoma (2%).
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