Better health and ageing for all Australians

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

Tier 2—Socio-economic factors—2.09 Index of disadvantage

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Why is it important?:

The links between different forms of disadvantage such as poverty, unemployment, poor education, racism and consequent social dysfunction, stress, social exclusion, and poor health are well documented (Wilkinson et al. 2003; Marmot 2005; Paradies 2006b; Saunders et al. 2007; Sassi 2009). This performance measure is a composite measure (an index) of advantage/disadvantage. It provides a broad basis for tracking progress in addressing Indigenous disadvantage across the spectrum of determinants of health.

The ABS has developed the Socio-Economic Indexes for Areas (SEIFA) to allow measurement of relative socioeconomic status at a small geographic area level (Adhikari 2006). These indexes summarise a range of socioeconomic variables associated with advantage and disadvantage such as the proportion of families with high incomes, people with a tertiary education, and employees in skilled occupations. The indexes provide an estimate of relative advantage and disadvantage. Scores are calculated for each area. Areas are then sorted by score and grouped into 5 or 10 groups (quintiles or deciles). Low values indicate areas that are relatively disadvantage, and high values indicate areas that are relatively advantaged.

Findings:

In 2006, Aboriginal and Torres Strait Islander peoples were over-represented in the three most disadvantaged deciles, ranked according to the ABS's SEIFA Index of Relative Socio-Economic Advantage/ Disadvantage. Thirty-one per cent of Indigenous Australians lived areas in the most disadvantaged decile (the bottom 10%), compared with 10% of the non Indigenous population. Only 2% of Indigenous Australians lived in areas in the most advantaged decile (the top 10%).

Analysis at the jurisdiction level suggests that in all states and territories a greater proportion of the Indigenous Australian population lived in the most disadvantaged quintile (bottom 20%) compared with the non-Indigenous population. The NT had the highest proportion (58%) and the ACT the lowest proportion (27%) of Aboriginal and Torres Strait Islander peoples living in the most disadvantaged quintile areas. NSW had the lowest proportion (3%) and the ACT the highest proportion (10%) of Indigenous Australians living in the most advantaged quintile areas (top 20%).

These results need to be interpreted with caution. Indigenous Australians often represent a small proportion of each Statistical Local Area (SLA) and therefore the socioeconomic status of the area will not always reflect the socioeconomic status of Indigenous Australians who live in the area. An analysis commissioned from the ABS's 2001 census-based SEIFA Index of Advantage/ Disadvantage (Kennedy et al. 2004), shows that Indigenous Australians in Qld have a high level of socioeconomic disadvantage regardless of whether they live in SLAs classified at area-level as having high or low socioeconomic status. The methodology used took the same weights developed for the overall SEIFA Index of Relative Socio-Economic Advantage/Disadvantage, but generated a separate score for Indigenous Australians compared with non-Indigenous Australians in each area. The results found that 93% of Aboriginal and Torres Strait Islander peoples in Qld were in the lowest decile for disadvantage. Of the approximately 126,000 Aboriginal and Torres Strait Islander people living in Qld in 2001, fewer than 2,000 had individual SEIFA scores in the top 5 deciles, even though 35,000 lived in SLAs coded to SEIFA scores in the top 5 deciles.

In order to address these shortcomings, Biddle (2009) constructed an Indigenous-specific index of relative socioeconomic outcomes, employing nine socioeconomic measures across employment, education, income and housing from the 2001 and 2006 Censuses. This study found that capital city regions ranked relatively well while remote regions ranked relatively poorly. However, within each region there was substantial variation across the smaller underlying Indigenous Areas. For example, while Sydney was the highest ranking Indigenous Area across all of Australia, the Indigenous population in areas such as Blacktown and Campbelltown had outcomes that were closer to those found in remote Australia. Similar variation was found in remote Indigenous Regions (Biddle 2009), demonstrating that any geographic strategy for addressing Indigenous disadvantage must target below the regional level.

An updated SEIFA index will be created from the 2011 Australian Census of Population and Housing and will be included in the next HPF report.

Implications:

This summary measure of disadvantage supplements what is known and reported in other measures about the relative disadvantage that Aboriginal and Torres Strait Islander peoples experience across a wide spectrum. Government policies to address social and economic disadvantage faced by Indigenous people are a vital component in closing the gap in health.

Poor health can also be a contributor to poor socioeconomic circumstances, in addition to being an outcome of those circumstances. A recent Australian study of people with serious chronic illnesses highlighted the financial stressors placed on people with these conditions and their carers (Jeon et al. 2009).

COAG has set six targets to close the gap in Indigenous disadvantage across health, education and economic participation. The commitments governments have made in this area are reflected in the National Indigenous Reform Agreement and the related national partnership agreements. This measure will therefore be a useful summary measure of progress in closing the gap in measured factors known to impact on health. However, it should be noted that the measure can only be estimated every five years with each Australian census and it is not possible to compare changes in socioeconomic outcomes over time. This is because both the geographic boundaries and indices used to construct the SEIFA differ between census years. Top of page
Figure 108Population distribution by SEIFA advantage/disadvantage decile, by Indigenous status, 2006
Figure 108—Population distribution by SEIFA advantage/disadvantage decile, by Indigenous status, 2006
Source: AIHW analysis of ABS 2006 Census of population and housing
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Figure 109Population distribution by SEIFA advantage/disadvantage quintiles, Indigenous population by state/territory and total population, 2006
Figure 109—Population distribution by SEIFA advantage/disadvantage quintiles, Indigenous population by state/territory and total population, 2006
Source: AIHW analysis of ABS 2006 Census of population and housing
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