ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLES

The health status of Australia's Aboriginal and Torres Strait Islander people is poor in comparison to the rest of the Australian population. On average, Indigenous Australians experience a higher burden of disease than non-Indigenous Australians (through kidney disease, diabetes, eye and hearing issues, as well as accidents and external injury). Indigenous Australians also experience higher rates of mortality than non-Indigenous Australians.

A number of factors help to explain why Aboriginal and Torres Strait Islander people have poorer health than other Australians. In general, Aboriginal and Torres Strait Islander people are more likely to experience disadvantage in terms of education, health education, unemployment, inadequate housing and infrastructure than other Australians. In particular, crowded housing has been identified as contributing to the spread of infectious diseases. Aboriginal and Torres Strait Islander Australians are also more likely to smoke, have poor diets and have high levels of obesity.

The health outcomes of the Aboriginal and Torres Strait Islander population are not consistent across Australia. Those who live in urban areas may have different outcomes than those who live in regional or remote localities. Access to appropriate health services is an issue for Aboriginal and Torres Strait Islander people, especially those in regional or remote localities.

Life expectancy and mortality

Life expectancy for Aboriginal and Torres Strait Islander men is estimated to be 11.5 years less than for non-Indigenous men (67.2 years and 78.7 years respectively). For Aboriginal and Torres Strait Islander women, the difference is 9.7 years (72.9 years for Aboriginal and Torres Strait Islander women and 82.6 years for non-Indigenous women) (ABS 2010e).

In 2008, Aboriginal and Torres Strait Islander deaths accounted for 1.7% of all deaths in Australia. This proportion was much larger in the Northern Territory (44.9%), reflecting the relatively high proportion (30% in 2006) of Aboriginal and Torres Strait Islander people in the Northern Territory.

In general, deaths of non-Indigenous people are concentrated in the older age groups, while deaths of Aboriginal and Torres Strait Islander people are more widely spread across all age groups. For example, for 2006-2008, age-specific death rates of Aboriginal and Torres Strait Islander people in South Australia, Western Australia and the Northern Territory combined were at least 7 times higher than non-Indigenous rates for both men and women aged 35-44, and at least 6 times higher for both men and women aged 45-54 (ABS 2009b).

In particular, death rates for 35-54 year old Aboriginal and Torres Strait Islander people were higher for Ischaemic heart disease, Diseases of the liver (i.e. Alcoholic liver disease and Cirrhosis of the liver), Diabetes and other forms of heart disease than non-Indigenous people in the same age group (ABS 20010g). For example, in 2006-2008, Indigenous age-specific death rates for ages 35-54 years for Ischaemic heart disease were 76.0 deaths per 100,000 Indigenous population in New South Wales and Queensland combined, and 149.6 deaths per 100,000 Indigenous population in South Australia, Western Australia and the Northern Territory combined. These rates compared with non-Indigenous age-specific death rates of 16.4 and 17.5 per 100,000 non-Indigenous population.

Infant mortality

The Aboriginal and Torres Strait Islander infant mortality rate varies across Australia. In New South Wales, the rate was 7.7 deaths per 1,000 live births in 2006-2008, compared with the non-Indigenous infant mortality rate of 4.3 deaths per 1,000 live births. In the Northern Territory, the Aboriginal and Torres Strait Islander infant mortality rate was over three times as high as the non-Indigenous infant mortality rate (13.6 deaths per 1,000 live births compared with 3.8 deaths per 1,000 live births).

Male Aboriginal and Torres Strait Islander infant mortality in the Northern Territory was about 15 deaths per 1,000 live births, while female Aboriginal and Torres Strait Islander infant mortality was 12 deaths per 1,000. For non-Indigenous males the rate was 4.4 deaths per 1,000 births and for females it was 3.3 deaths per 1,000 (ABS 2009b).

Between 1998 and 2008 the Indigenous to non-Indigenous rate ratio (the Aboriginal and Torres Strait Islander rate divided by the rate for other Australians) for infant mortality declined in the Northern Territory an average of 1.7% per year, while the rate difference (the Aboriginal and Torres Strait Islander rate minus the rate for other Australians) almost halved from 18.1 to 9.8 deaths per 1,000 births which suggests that the gap between Aboriginal and Torres Strait Islander and non-Indigenous infant mortality in the Northern Territory has reduced (ABS 2009b).

External causes of death

Aboriginal and Torres Strait Islander Australians experience relatively high rates of injury and death from accidents and violence (ABS 2008c). In 2008, 16% of all Aboriginal and Torres Strait Islander deaths were attributed to External causes, compared with 5.9% of non-Indigenous deaths. Almost two-thirds (66%) of Aboriginal and Torres Strait Islander deaths due to External causes occurred amongst men. Intentional self harm (suicide) (4.2% of all Aboriginal and Torres Strait Islander deaths) and Land transport accidents (4.0%) were the leading External causes of death for Aboriginal and Torres Strait Islander people (ABS 2010a).

Risk factors

As with the Australian population as a whole, the proportion of Aboriginal and Torres Strait Islander people who are daily current smokers has declined. In 2008, 45% of Aboriginal and Torres Strait Islander Australians (aged 15 years and over) were current daily smokers, compared with 49% in 2002. This is the first statistically significant decrease in Aboriginal and Torres Strait Islander smoking rates reported since 1994 although Aboriginal and Torres Strait Islander people are still twice as likely to be current daily smokers as non-Indigenous people. The proportion of Aboriginal and Torres Strait Islander people aged 15 years and over who reported drinking alcohol at levels considered risky or high risk to health in the long-term was similar in 2008 (17%) to what it was in 2002 (15%) (ABS 2010e).

Self-assessed health and psychological distress

In 2008, Aboriginal and Torres Strait Islander Australians reported poorer self-assessed health than non-Indigenous Australians, and were more likely to report higher levels of psychological distress. After adjusting for age differences, Aboriginal and Torres Strait Islander people (aged 15 years and over) were twice as likely as non-Indigenous people to report fair/poor health. This gap has remained unchanged since 2002 (ABS 2010e).

The rate of high or very high levels of psychological distress for Aboriginal and Torres Strait Islander Australians (aged 18 years and over) was also more than twice that of non-Indigenous Australians (ABS 2010e).