Better health and ageing for all Australians

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

Tier 1—Human function—1.13 Community Functioning

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Why is it important?:

Aboriginal and Torres Strait Islander peoples have long sought health outcomes encompassing the physical, social, cultural and emotional elements of life. This includes the ability to live proudly and freely as Aboriginal and Torres Strait Islander peoples. Functioning is about the things people achieve or experience, consistent with their account of wellbeing. The conversion of capabilities into functioning is influenced by the values and personal features of individuals, families and communities and by the environment in which they live. Hence it is likely that different cultures will give greater or lesser priority to different aspects of functioning (Office of Aboriginal Health et al. 2004).

To develop a picture of family and community functioning from Aboriginal and Torres Strait Islander peoples' perspectives, workshops drawing together participants from across Australia were held in 2008 and 2010. Participants at the workshops described the various elements of family and community life essential for high levels of functioning. The workshops identified a number of key themes and weighted these functionings according to their relative value. In 2010 there were six themes identified by Aboriginal and Torres Strait Islander participants and these have been used to analyse and present available data.

Participants were drawn from a number of jurisdictions and settings so the themes they identified appear to reflect widely held views among Aboriginal and Torres Strait Islander peoples. Independently of these workshops a review of relevant research has supported the association between the functionings identified by the workshops and the achievement of health and wellbeing.Top of page

Aboriginal and Torres Strait Islander peoples have sought, and continue to seek, a quality of life where racism ceases to be a barrier. Racism in any of its institutional, interpersonal and internalised settings can deter people from achieving their full capabilities (Ziersch et al. 2011).

Findings:

Outlined below is a description of each of the six themes and the key findings for Aboriginal and Torres Strait Islander peoples, using data from the 2008 NATSISS:

Connectedness to country, land, and history; culture and identity

  • Being connected to country, land, family and spirit
  • Strong and positive social networks with Aboriginal and Torres Strait Islander peoples
  • Strong sense of identity and being part of a collective
  • Sharing; giving and receiving; trust; love; looking out for others
Data from the 2008 NATSISS show:
  • 72% of Aboriginal and Torres Strait Islander peoples aged 15 years and over recognised their homelands.
  • 62% identified with a clan or language group, up from 54% in 2002.
  • 89% 'feel able to have a say with family and friends' some, most or all or the time. This is associated with excellent or very good self-assessed health status and low to moderate levels of psychological distress.
  • 94% had contact with family or friends outside the household at least once per week.
  • 75% had friends to confide in.
  • 51% provided support to relatives outside the household.
  • 63% had attended a cultural event in the last 12 months.

Resilience

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  • Coping with the internal and external world
  • Power to control options and choices
  • Ability to proceed in public without shame
  • Optimising what you have
  • Challenge injustice and racism, stand up when required
  • Cope well with difference, flexibility, accommodating
  • Ability to walk in two worlds
  • Engaged in decision-making
  • External social contacts
Data from the 2008 NATSISS show:
  • 69% of Aboriginal and Torres Strait Islander peoples aged 15 years and over reported that they did not avoid situations due to past discrimination.
  • 80% agreed that their doctor could be trusted and 69% agreed that the local school could be trusted.
  • 89% felt they were able to find general support from outside the household.
  • 56% had provided support to someone outside their household in the last four weeks.
  • 89% had participated in sport, social or community activities in the three months prior to the survey.
  • 54% in non-remote areas knew someone in an organisation they would feel comfortable contacting.
  • 44% of employed people said work allowed them to fulfil cultural responsibilities.

Leadership

  • Strong elders in family and community, both male and female
  • Role models, both male and female
  • Strong direction, vision
  • The 'rock', someone who has time to listen and advise
Data from the 2008 NATSISS show:
  • 42% of children aged 3–14 years had spent time with an Indigenous leader or Elder in the last week. In remote areas this increased to 63%.
Additional data items which describe values of leadership would be useful in future social surveys.
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Having a role, structure and routine

  • Having a role for self: participation, contributing through paid and unpaid roles
  • Capabilities and skills derived through social structures and experience through non-formal education
  • Knowing boundaries and acceptable behaviours
  • Sense of place—knowing your place in family and society
  • Being valued and acknowledged
  • Disciplined
Data from the 2008 NATSISS show:
  • 78% of Aboriginal and Torres Strait Islander peoples had lived in only one dwelling in the last 12 months. This was associated with low to moderate levels of psychological distress and being employed.
  • 73% were in households that had not experienced cash flow problems in the last 12 months.
  • 86% were in households in which there had been no days without money for basic living expenses in the last two weeks.
  • Most children aged 0–14 years (94%) had participated in informal learning activities with their main carer.

Feeling safe

  • Lack of physical and lateral violence
  • Safe places
  • Emotional security
  • Cultural competency
  • Relationships that can sustain disagreement
Data from the 2008 NATSISS show:
  • 75% had not experienced physical and/or threatened violence in the last 12 months.
  • 80% felt safe at home alone after dark. This was associated with excellent or very good self-assessed health and low to moderate levels of psychological distress.
  • In the five years prior to the survey, 97% of Aboriginal and Torres Strait Islander peoples had not been incarcerated (91% had never been incarcerated in their lifetime).
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Vitality

The final theme, Vitality, covers community infrastructure, access to services, education, health, income and employment.

Data from the 2008 NATSISS show:
  • half of Aboriginal and Torres Strait Islander peoples aged 15 years and over had no disability or long-term health condition.
  • 68% of those aged 15 years and over had experienced low/moderate levels of psychological distress in the four weeks before the survey.
  • 76% of children aged 0–14 years did not have problems sleeping.
  • 74% of children aged 4–14 years spent at least 60 minutes every day being physically active.
  • 74% of people aged 15 years and over said they can easily get to places as needed. This was associated with feeling able to have a say with family and friends in the community and providing support to relatives.
  • Many Aboriginal and Torres Strait Islander people were seeking to improve their knowledge, skills and qualifications, with 41% of those aged 15 years and over (who were not currently studying) intending to study in the future.
  • Education was the main purpose of Internet use for children (54%), while 30% of those aged 5 years and over reported using the Internet for education or study.

Implications:

Community functioning for Aboriginal and Torres Strait Islander peoples should be assessed within a framework that reflects their own values. Community functioning scores present a national quantitative measure of functioning and suggest differences between remoteness, sex, age groups, and states and territories. Policy makers need to listen carefully to the voices of Aboriginal and Torres Strait Islander peoples when assessing community functioning and the approaches that will enhance functioningTop of page
Figure 51—Community functioning score by remoteness, proportions, Indigenous Australians aged 0-14 years, 2008
Figure 51—Community functioning score by remoteness, proportions, Indigenous Australians aged 0-14 years, 2008
Source: ABS and AIHW analysis of NATSISS 2008
Figure 52—Community functioning score by remoteness, proportions, Indigenous Australians aged 15 years and over, 2008
Figure 52—Community functioning score by remoteness, proportions, Indigenous Australians aged 15 years and over, 2008
Source: ABS and AIHW analysis of NATSISS 2008
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Table 13—Selected variables contributing to community functioning among Aboriginal and Torres Strait Islander peoples, 2008 and 2002

Connectedness to family land and history, culture, identity

Community functioning theme and associated variables2008 Number2008(a)
%
2002(a)
%
Recognises homelands
234,383
72
70
Speaks an Aboriginal/Torres Strait Islander language
62,629
19
21
Attended Aboriginal and Torres Strait Islander cultural event in last 12 months
205,674
63
68
Identifies with clan group or language group
203,106
62
54
Feels able to have a say with family and friends some, most or all of the time
292,375
89
Feels able to have a say within community on important issues some, most and all of the time
157,312
48
Contact with family or friends outside household at least once per week
307,515
94
Has friends can confide in
246,649
75
Able to get support in time of crisis from outside household—from family member
261,506
80
Provides support to relatives outside household
166,892
51
(a)Unless otherwise indicated percentages are of the estimated total Aboriginal and Torres Strait Islander population aged 15 years and over. Where another population is indicated, this has been used to calculate the percentage. Source: ABS and AIHW analysis of NATSISS 2002 and 2008
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Resilience

Community functioning theme and associated variables2008 Number2008(a)
%
2002(a)
%
Did not feel discriminated against in last 12 months
237,812
73
Did not avoid situations due to past discrimination
225,507
69
Can visit homelands
146,017
45
46
Involvement with Aboriginal/Torres Strait Islander organisation
59,516
18
26
Work allows for cultural responsibilities to be met (employed persons)
75,028
44
22
Household member(s) used strategies to meet basic living expenses in last 12 months
119,147
36
49
No community problems reported
84,327
26
25
Community problems reported, but less than three types
73,788
23
29
Theft not reported as a neighbourhood/community problem
192,535
59
57
Alcohol not reported as a neighbourhood/community problem
192,138
59
67
Illegal drugs not reported as a neighbourhood/community problem
208,039
64
68
Family violence not reported as a neighbourhood/community problem
245,938
75
79
Assault not reported as a neighbourhood/community problem
253,009
77
80
Sexual assault not reported as a neighbourhood/community problem
288,926
88
92
Total persons who reported a community problem
232,592
71
74
Agrees that most people can be trusted
118,975
36
Agrees that their doctor can be trusted
260,777
80
Agrees that the hospital can be trusted
204,189
62
Agrees that police in the local area can be trusted
170,317
52
Agrees that police outside the local area can be trusted
133,362
41
Agrees that the local school can be trusted
224,734
69
Knows someone in organisation that is comfortable contacting (non-remote areas)
132,011
54
Felt able to find general support from outside the household
291,459
89
Provided support to someone outside household in last 4 weeks
184,537
56
Participated in sport/social/community activities in last 3 months
289,381
89
Recreational or cultural group
46,263
14
Community or special interest group activities
42,274
13
Church or religious activities
49,393
15
24
Watched Indigenous TV
177,695
54
Listened to Indigenous radio
85,682
26
(a)Unless otherwise indicated percentages are of the estimated total Aboriginal and Torres Strait Islander population aged 15 years and over. Where another population is indicated, this has been used to calculate the percentage. Source: ABS and AIHW analysis of NATSISS 2002 and 2008
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Leadership

Community functioning theme and associated variables2008 Number2008(a)
%
2002(a)
%
Child spent time with an Indigenous leader or elder in last week (3-14 years)
65,035
42
Encouragement from elders and council would help child to complete Year 12 (2-14 years)
7,504
5
Encouragement from elders and council would help child in secondary school to complete Year 12 (15-19 years)
3,251
5
Structure and routine/having a role
Can communicate with English speakers without difficulty (Indigenous language is main language spoken at home)
27,179
72
Has lived in only one dwelling for the past year or longer
255,157
78
69
Child involved in informal learning activities with carer in last week (0-14 years)
180,736
94
(a)Unless otherwise indicated percentages are of the estimated total Aboriginal and Torres Strait Islander population aged 15 years and over. Where another population is indicated, this has been used to calculate the percentage. Source: ABS and AIHW analysis of NATSISS 2002 and 2008
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Feeling Safe

Community functioning theme and associated variables2008 Number2008(a)
%
2002(a)
%
Felt safe at home alone during the day
305,892
94
Felt safe at home alone after dark
261,414
80
Felt safe walking alone in local area after dark
172,047
53
Not a victim of physical or threatened violence in the last 12 months
246,372
75
76
Indigenous culture taught at school
87,833
53
Was taught Indigenous culture at school or as part of further studies
148,592
45
Learnt about own Indigenous clan/language
55,947
17
Child neither bullied nor treated unfairly at school because Indigenous
112,159
81
Not incarcerated in the last 5 years
316,033
97
93
Never incarcerated
297,030
91
(a)Unless otherwise indicated percentages are of the estimated total Aboriginal and Torres Strait Islander population aged 15 years and over. Where another population is indicated, this has been used to calculate the percentage. Source: ABS and AIHW analysis of NATSISS 2002 and 2008
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Vitality

Community functioning theme and associated variables
2008 Number
2008(a)
%
2002(a)
%
Self-assessed health status excellent or very good
143,004
44
44
Has no disability or long-term health condition
164,157
50
64
Does not have an education restriction due to disability (15-64 years)
143,701
46
Does not have an employment restriction due to disability (15-64 years)
126,681
41
Low/ moderate level of psychological distress (5-11 K5 score)
221,717
68
Employed (persons aged 15-64 years in the labour force)
167,416
54
Year 12 highest year of school completed (excluding secondary school students)
66,220
22
18
Has a non-school qualification (25-64 years)
83,257
40
32
Living in a dwelling that has no major structural problems (all ages)
370,606
71
60
Household members used telephone(s) in last month
317,203
97
Used computer in last 12 months
218,006
67
56
Used Internet in last 12 months
192,852
59
41
Has access to motor vehicles whenever needed
215,689
66
55
Can easily get to places needed
241,481
74
70
Equivalised gross household income is within the 3rd quintile or above (persons in households with all income reported)
74,628
29
25
Total persons aged 15 years and over
327,101
100
(a)Unless otherwise indicated percentages are of the estimated total Aboriginal and Torres Strait Islander population aged 15 years and over. Where another population is indicated, this has been used to calculate the percentage. Source: ABS and AIHW analysis of NATSISS 2002 and 2008
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