Share on Facebook Share on Twitter Share on LinkedIn Share on Google+ Share by Email

Skip to content

Key resources

  • Bibliography
    Bibliography
  • Health promotion
    Health promotion
  • Health practice
    Health practice
  • Programs
    Programs
  • Conferences
    Conferences
  • Courses
    Courses
  • Funding
    Funding
  • Jobs
    Jobs
  • Organisations
    Organisations
  • Health Services MapHealth Services Map
Australian Indigenous HealthBulletin Alcohol and other drugs knowledge centre Yarning Places
 

Injury, including family violence

Please select category from the dropdown list below.

Injury, including family violence

Injury includes both physical harm to a person's body and non-physical harm, including grief, loss and suffering [1], but in public health practice attention is almost entirely confined to physical harm [2]. Even restricted to physical harm, assessing the total impact of injury is difficult because many injuries do not result in hospitalisation or death and there are few systematic data [3].

The classification of injury has generally followed the WHO's ICD, which includes particular attention to the external cause and intention of the injury [4].30 Understanding injury for Aboriginal and Torres Strait Islander people, needs to take into consideration a diverse range of issues, including low socio-economic contexts with a higher risk of injury because of unsafe environments [3][5], alcohol and other drug use, intimate partner violence [6], disruption to culture [1], as well as less access to prevention efforts and high-quality treatment and rehabilitation services.

Extent of injury among Aboriginal and Torres Strait Islander people
Prevalence

The 2012-2013 AATSIHS reported that 2.5% of Aboriginal and Torres Strait Islander people had a long-term condition caused by injury with the highest reported levels in the 35-44 and 45-54 years age-groups [7][8]. Long-term conditions caused by injury were reported more frequently by Aboriginal and Torres Strait Islander people than by non-Indigenous people across all age-groups except for the 55 years and over age-group [7]. After age-adjustment, Aboriginal and Torres Strait Islander people were 1.2 times more likely than non-Indigenous people to report a long-term condition as a result of an injury; the rate ratio for females (1.3) was slightly higher than for males (1.1) [8].

In relation to violence, in the 2014-2015 NATSISS, 22% of Aboriginal and Torres Strait Islander people aged 15 years and over had experienced physical or threatened violence in the last 12 months [9]. For males, victimisation was highest in the 15-24 years age-group (27%), while for females, it was highest in the 25-34 years age-group (27%). Males experienced physical or threatened violence at a slightly higher rate than females (23% and 22% respectively). In terms of remoteness, victimisation levels were slightly higher in remote areas (23%) than they were in non-remote areas (22%).

According to the 2014-2015 NATSISS, 69% of Aboriginal and Torres Strait Islander people aged 15 years or over reported awareness of problems in their neighbourhood or community, with 25% reporting awareness of family violence and 21% reporting awareness of assault [9]. For remote areas, 47% of Aboriginal and Torres Strait Islander people reported awareness of family violence, compared with 19% for non-remote areas. The figures are similar for assault, with 45% of Aboriginal and Torres Strait Islander people in remote areas reporting awareness of assault, compared with 14% in non-remote areas.

Hospitalisation

There were 29,237 hospital separations for injuries for Aboriginal and Torres Strait Islander people in 2014-15, representing 13% of all Aboriginal and Torres Strait Islander separations (excluding those for dialysis) [10]. The leading external causes of injury-related hospitalisations were falls (20%), assault (19%), exposure to mechanical forces (17%) and complications of medical and surgical care (14%). After age-adjustment, the separation rate for injury was almost twice as high for Aboriginal and Torres Strait Islander people than for other Australians (47 per 1,000 and 26 per 1,000 respectively).

More detailed information for 2012-13 shows that in terms of age, the greatest disparity between Aboriginal and Torres Strait Islander and non-Indigenous people was in the 30-34 years age-group, where the rate of hospitalised injury was 3.6 times higher for Aboriginal and Torres Strait Islander people [11]. The highest proportion of injury for Aboriginal and Torres Strait Islander people however, was in the 25-44 years age-group (42% for females, and 36% for males). Rates of hospitalised injury are consistently higher for Aboriginal and Torres Strait Islander people in the middle years, however from about 65+ years, the rates are high for both Aboriginal and Torres Strait Islander people and non-Indigenous people.

In terms of remoteness, hospitalisation rates for injury for Aboriginal and Torres Strait Islander people increased with remoteness in 2014-15 [12]. The rate increased from 38 per 1,000 in major cities to 74 per 1,000 in remote and very remote areas. Hospitalisation rate ratios (Aboriginal and Torres Strait Islander/non-Indigenous) were higher in remote areas than major cities for a number of principal diagnoses, notably so for assaults, where the rate ratio for remote and very remote areas (19.0) was more than twice that of major cities (7.6).

Assaults account for a higher proportion of injury-related hospitalisations among Aboriginal and Torres Strait Islander people than among non-Indigenous people; in 2014-15, 19% of injury-related hospitalisations among Aboriginal and Torres Strait Islander people were for assaults compared with 2% among other Australians [10].

Rates of hospitalisations due to family violence-related assaults among Aboriginal and Torres Strait Islander people were higher than their non-Indigenous counterparts in 2014-15 [12]. After age-adjustment, Aboriginal and Torres Strait Islander people were hospitalised for assaults relating to family violence at 29 times the rate of non-Indigenous people. The hospitalisation rates for family violence-related assaults for Aboriginal and Torres Strait Islander females were highest for those aged 25-34 years (13 per 1,000). For Aboriginal and Torres Strait Islander males, rates were highest for those aged 35-44 years (4.3 per 1,000). The hospitalisation rates from family violence-related assaults for Aboriginal and Torres Strait Islander people increased with remoteness, from 4.0 per 1,000 in major cities to 15 per 1,000 in remote areas (rate ratios: 13.8 and 41.7 respectively when compared with the age-standardised rates for non-Indigenous people).

Mortality

Important specific causes of injury deaths in 2015 were intentional self-harm (152 deaths, 5.3% of all Aboriginal and Torres Strait Islander deaths), land transport accidents (84 deaths, 2.9% of all Aboriginal and Torres Strait Islander deaths), accidental poisoning (60 deaths, 2.1% of all Aboriginal and Torres Strait Islander deaths) and assault (48 deaths, 1.7% of all Aboriginal and Torres Strait Islander deaths) [13]. After age-adjustment, deaths from intentional self-harm were twice as common for Aboriginal and Torres Strait Islander people than for non-Indigenous people, and those from land transport accidents 2.9 times as common. After age-adjustment, the death rate for injury from assault was 8.2 times higher.

The most recent detailed information for death from injury is available for the five-year period 2008-2012. In this period, there were 1,766 Aboriginal and Torres Strait Islander deaths from injury in NSW, Qld, WA, SA and the NT, representing 15% of all Aboriginal and Torres Strait Islander deaths [14]. After age-adjustment Aboriginal and Torres Strait Islander people died from injury at twice the rate of non-Indigenous people. Death rates for injury were particularly high among Aboriginal and Torres Strait Islander people aged 25-34 years (107 per 100,000), 35-44 years (103 per 100,000) and 75+ years (171 per 100,000 respectively).

Leading causes of injury-related death of Aboriginal and Torres Strait Islander people for 2008-2012 in NSW, Qld, WA, SA and the NT, as a percentage of total deaths were for intentional self-harm (6.4% for males and 2.9% for females), land transport accidents (4.8% for males and 2.8% for females), accidental poisoning by and exposure to noxious substances (2.0% for males and 1.4 for females) and assault (1.8% for males and 1.4 for females) [15].

References

  1. National Public Health Partnership (2005) The national Aboriginal and Torres Strait Islander safety promotion strategy. Canberra: National Public Health Partnership
  2. National Public Health Partnership (2005) The national injury prevention and safety promotion plan: 2004-2014. Canberra: National Public Health Partnership
  3. Clapham K, O’Dea K, Chenhall R (2007) Interventions and sustainable programs. In: Carson B, Dunbar T, Chenhall RD, Bailie R, eds. Social determinants of Indigenous health. Crows Nest, NSW: Allen and Unwin: 271-295
  4. World Health Organization (2015) International Statistical Classification of Diseases. Retrieved 2015 from http://apps.who.int/classifications/icd10/browse/2015/en#/XIX/
  5. WHO (2016) Q&As: injuries. Retrieved 2016 from http://www.who.int/topics/injuries/qa/en/
  6. Australian Institute of Health and Welfare (2016) Australian Burden of Disease Study: impact and causes of illness and death in Australia 2011. Canberra: Australian Institute of Health and Welfare
  7. Australian Bureau of Statistics (2014) Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13: Table 6 [data cube]. Retrieved 26 March 2014 from
  8. Australian Bureau of Statistics (2013) Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13: Table 5 [data cube]. Retrieved 27 November 2013 from http://www.abs.gov.au/AUSSTATS/subscriber.nsf/log?openagent&table%205%20long-term%20conditions%20by%20sex%20by%20indigenous%20status,%202012-13%20-%20australia.xls&4727.0.55.001&Data%20Cubes&5C97CE7DA7059C06CA257C2F00145D5A&0&2012-13&27.11.2013&Latest
  9. Australian Bureau of Statistics (2016) National Aboriginal and Torres Strait Islander Social Survey, 2014-15. Canberra: Australian Bureau of Statistics
  10. Australian Institute of Health and Welfare (2016) Admitted patient care 2014-15: Australian hospital statistics. Canberra: Australian Institute of Health and Welfare
  11. Pointer S (2015) Trends in hospitalised injury, Australia: 1999-00 to 2012-13. Canberra: Australian Institute of Health and Welfare
  12. Steering Committee for the Review of Government Service Provision (2016) Overcoming Indigenous disadvantage: key indicators 2016 report. Canberra: Productivity Commission
  13. Australian Bureau of Statistics (2016) Causes of Death, Australia, 2015. Retrieved 28 September 2016 from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2015~Main%20Features~Summary%20of%20findings~1
  14. Australian Institute of Health and Welfare (2015) Aboriginal and Torres Strait Islander health performance framework 2014: data tables. Retrieved 11 June 2015 from http://www.aihw.gov.au/indigenous-data/health-performance-framework/
  15. Australian Institute of Health and Welfare (2015) Aboriginal and Torres Strait Islander health performance framework 2014 report: detailed analyses. Canberra: Australian Institute of Health and Welfare
  16. Moller J (1996) Understanding national injury data regarding Aboriginal and Torres Strait Islander peoples. Australian Injury Prevention Bulletin; 14(December): 1-8

Footnotes

30. This system is followed in this section, but it has its limitations (for more details, see [16]).

 

Table of Contents

collapseCollapse
expand Expand
    Last updated: 24 March 2017
     
    Return to top
    spacing
    general box

    Contribute

    Share your information » Give us feedback » Sign our guestbook »
    spacing
    spacing