The context of Indigenous health

Indigenous population

Estimates of the numbers of Aboriginal and Torres Strait Islander people for 2009 from the ABS indicate that there were 550,818 Indigenous people living in Australia at 30 June 2009 ^[1]. NSW had the largest Indigenous population with 161,910, followed by Qld (156,454), WA (74,859), and the NT (67,441) (Table 1). The NT had the highest proportion of Indigenous people among its population (30.2%) and Vic the lowest (0.7%).

The estimated Indigenous population increased by around 58,700 between 2001 and 2006, with the largest increases documented for WA (18%), the NT (17%) and Qld (16%) ^[3].

The majority of Indigenous people live in cities and towns, but the Indigenous population is much more widely dispersed across Australia than is the non-Indigenous population. Slightly more than one-half of the Indigenous population lives in areas classified as ‘major cities' or ‘inner regional' areas, compared with almost nine-tenths of the non-Indigenous population ^[3]. (As well as these two classifications of ‘remoteness' in terms of access to goods and services and opportunities for social interaction, the Australian Standard Geographical Classification (ASGC) has four other categories: ‘outer regional', ‘remote', ‘very remote' and ‘migratory' ^[4].) Almost one-quarter of Indigenous people live in areas classified as ‘remote' or ‘very remote' in relation to having ‘very little or very restricted access to goods and services and opportunities for social interaction'. Only 2% of non-Indigenous people live in ‘remote' or ‘very remote' areas.

In terms of specific geographical areas, more than one-half of all Indigenous people live in nine of the 37 Indigenous Regions (based largely on the former Aboriginal and Torres Strait Islander Commission (ATSIC) regions): Sydney; Brisbane; Coffs Harbour; Perth; Townsville, Cairns; Adelaide; Tasmania; and Wagga Wagga ^[3].

Detailed population information is not available for 2009, but in 2006 there were around 463,900 were Aboriginal, 33,100 Torres Strait Islander, and 20,200 people of both Aboriginal and Torres Strait Islander descent ^[3]. Most Torres Strait Islander people live in Qld, with NSW the only other state with a large number of Torres Strait Islanders.

The Indigenous population is much younger overall than the non-Indigenous population ^[3]. According to the 2006 Australian census, about 37% Indigenous people were aged less than 15 years, compared with 19% of non-Indigenous people (Figure 1). About 3% of Indigenous people were aged 65 years or over, compared with 13% of non-Indigenous people.

Figure 1 Population pyramid of Indigenous and non-Indigenous populations, 2009

The socioeconomic context

There is an irrefutable relationship between the social inequalities experienced by Indigenous people and their current health status ^[5]. This social disadvantage, directly related to dispossession and characterised by poverty and powerlessness, is reflected in measures of their education, employment, and income. Thus, prior to presenting the key indicators of Indigenous health status, it is important to provide a brief summary of the context within which these indicators should be considered.

The key measures in these areas for Indigenous people nationally include:

Education

According to the 2006 Australian census:

• 88% of five year old Indigenous children and 95% of five year old non-Indigenous children were attending an educational institution;
• 2.5% of the Indigenous population had not attended school compared with 0.9% of the non-Indigenous population;
• one-third (32%) of Indigenous people reported year 10 as their highest year of school completion and less than one-quarter (22%) completed year 12 compared with almost one-half (47%) of non-Indigenous people;
• one-quarter (25%) of Indigenous people reported having a post school qualification, compared with almost one-half (47%) of non-Indigenous people; and
• 4.1% of non-Indigenous people reported attending a university, compared with 1.7% of Indigenous people ^[6].

An ABS school report revealed:

• in 2008 the apparent retention rate for Indigenous students from year 7/8 to year 10 was 89% and from year 7/8 to year 12 was 46%; and
• for non-Indigenous students, the apparent retention rate from year 7/8 to year 10 was 100% compared with 76% for non-Indigenous students from year7/8 to year 12 ^[7].

The 2008 national report on schooling in Australia showed:

• 68% of Indigenous students in year three and 63% in year five achieved the national reading benchmark, compared with 94% and 93% respectively of all Australian students
• 65% of year three Indigenous students and 64% of year five Indigenous students achieved the national benchmark for grammar and punctuation compared with 93% of all year three students and 94% of year five students; and
• 79% of Indigenous students in year three and 69% in year five achieved the national numeracy benchmark, compared with 96% and 94% respectively of all Australian students ^[8].

Employment

According to the 2006 Australian census:

• 46% of Indigenous people aged 15 years or older were employed, 8.5% were unemployed, and 46% were not in the labour force. In comparison, 62% of non-Indigenous people aged 15 years or older were employed, 3.3% were unemployed, and 35% were not in the labour force
• excluding people employed under the Community Development Employment Project (CDEP) scheme increases the unemployment rate for Indigenous people to approximately 25% - five times the rate of 5% for non-Indigenous people;
• the most common occupation classification of employed Indigenous people was ‘labourer' (24%). The most common occupation classification of employed non-Indigenous people was ‘professional' (20%) ^[6].

Income

According to the 2006 Australian census: 

• the mean equivalised gross household income for Indigenous persons was $460 per week - approximately 62% of that for non-Indigenous people ($740);
• 45% of the Indigenous population were in the lowest income quintile (mean equivalised gross household income of less than $315 per week). The non-Indigenous population was almost evenly distributed among the five income quintiles;
• the median gross individual income for Indigenous people was $278 per week compared with $473 for non-Indigenous people; and
  
• professionals' were the highest median gross weekly income earners and ‘labourers' were the lowest but Indigenous people earned 28% less and 16% less than non-Indigenous people in these occupations ^[6].

References

1. Australian Bureau of Statistics (2009) Experimental estimates and projections, Aboriginal and Torres Strait Islander Australians 1991 to 2021 Canberra: Australian Bureau of Statistics
2. Australian Bureau of Statistics (2009) Australian demographic statistics, Mar 2009 Canberra: Australian Bureau of Statistics
3. Australian Bureau of Statistics (2007) Population distribution, Aboriginal and Torres Strait Islander Australians Canberra: Australian Bureau of Statistics
4. Australian Bureau of Statistics (2001) Statistical geography, volume 1: Australian Standard Geographical Classification (ASGC), 2001 Canberra: Australian Bureau of Statistics
5. Carson B, Dunbar T, Chenhall RD, Bailie R, eds. (2007) Social determinants of Indigenous health Crows Nest, NSW: Allen and Unwin
6. Australian Bureau of Statistics (2008) Population characteristics, Aboriginal and Torres Strait Islander Australians: 2006 Canberra: Australian Bureau of Statistics
7. Australian Bureau of Statistics (2009) Schools, Australia, 2008 Canberra: Australian Bureau of Statistics
8. Ministerial Council for Education Early Childhood Development and Youth Affairs (2008) National assessment program: literacy and numeracy report Canberra: Ministerial Council for Education, Early Childhood Development and Youth Affairs