Australian Indigenous

Australian Bureau of Statistics & Australian Institute of Health and Welfare (2001)
The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples 2001.
Canberra: A joint program of the Australian Bureau of Statistics and the Australian Institute of Health and Welfare.

This publication, the third of a two-yearly series that commenced in 1997, provides an up-to-date overview of Indigenous health and welfare. The information contained in the report is drawn primarily from national data although state and regional information is provided where quality data is available.

The report does not purport to cover all of the many complex issues that impact on the health and wellbeing of the Indigenous population but it does provide a wealth of information on:

• demographic, social and economic indicators
• housing and infrastructure
• community services and housing assistance
• availability, cost and use of health services
• health status, including measures of life expectancy, mortality, maternal and child health, mental health and hospitalisation

In addition, separate chapters provide an analysis of the nature and prevalence of diabetes in the Indigenous population and an overview of recent initiatives to improve the quality and availability of Indigenous statistics.

The report provides ample evidence that Indigenous Australians continue to suffer a greater burden of ill health than the rest of the population - they have higher death rates, shorter life expectancy, and are more likely to be hospitalised than other Australians. The report also documents differences in patterns of health expenditure that reflect, in part, differences in Indigenous and non-Indigenous access to health services . Overall, Indigenous people continue to experience lower levels of access to health services than the general population.
Australian Indigenous HealthInfoNet abstract

A summary of the report is available from the ABS site. Enquiries about purchasing a copy of this report should be directed to the ABS Bookshop in your capital city.

AusStats subscribers and authorised Australian universities may download the report in PDF format. If you are not an AusStats subscriber or authorised Australian university user and would like to purchase a copy of this product, please call the ABS National Information Service on 1300 135 070. Please have the catalogue number (4704.0), filename and your credit card details ready. Extra labour and handling charges may apply for ABS-assisted access to this dataset.

Australian Institute of Health and Welfare (2001)
Expenditures on health services for Aboriginal and Torres Strait Islander people 1998-99.
Canberra: Australian Institute of Health and Welfare and Commonwealth Department of Health and Aged Care.

This Australian Institute of Health and Welfare report reviews expenditure for provision of health services to Aboriginal and Torres Strait Islander people by Australian governments and the private sector for the 1998-1999 financial year. Its findings are similar to the first report for 1995-96 in that total expenditure per
person for health services for Aboriginal and Torres Strait Islander people was not much higher than for the total Australian population.

Estimated total expenditure in 1998-99 was $1,245 million, which is equivalent to $3,065 per person compared with $2,518 per person for non-Indigenous people - a ratio of 1.22:1. When relative income position was taken into account, public expenditure on the health of Aboriginal and Torres Strait people appeared to be similar to that for non-Indigenous people in low-income groups, despite the much lower health status of Aboriginal and Torres Strait people.

The majority of Indigenous health expenditure was allocated through mainstream health programs which generally do not, or only incompletely, document use specifically by Aboriginal and Torres Strait Islander people. Medicare data, for example, do not include an Indigenous identifier. The use of surveys and other estimation techniques were used in this review, because of inadequate or incomplete routine data.

Indigenous people were, on average, much higher users than non-Indigenous people of publicly funded health services and State-funded health services, particularly admitted patient services in hospitals and community health services. Compared with non-Indigenous people, Indigenous people used fewer private services such as doctors in private practice, private hospitals, dentists and privately funded allied health professionals.

The Commonwealth and State governments contributed very similar amounts to health services for Aboriginal and Torres Strait Islander people. Over 50% of the Commonwealth's contribution was indirect through its contribution to public hospital funding. Expenditures were much lower for Aboriginal and Torres Strait Islander people than for other Australians in the major Commonwealth-funded health programs, Medicare and the Pharmaceutical Benefits Scheme. Per person expenditure on Indigenous people was 37% of that for non-Indigenous people.

The report noted that the ratio of Indigenous to non-Indigenous service use would be lower that the expenditure ratio of 1.22:1 if the higher costs of providing service in remote areas could be factored in. The analysis documented decreasing levels of access to Medicare funded services and pharmaceutical benefits as remoteness increased, but admitted patient expenditure increased with increasing remoteness.

The report noted also that there were problems in comparing expenditures for 1998-99 with those for 1995-96 because of changes in methodology and data availability. It concluded, however, that, after controlling for population and inflation, there are areas in which there had been increases in funding and service provision.

Australian Indigenous HealthInfoNet Abstract

Click here to view the full text document
Click here to view the media release

To enquire about obtaining a hard copy of this report, contact the Australian Institute of Health through their Internet site: http://www.aihw.gov.au. The report may be available also from Commonwealth Government Info Shops and agents in capital cities.

Condon JR, Warman G, Arnold L (2001)
The health and welfare of Territorians.
Casuarina: Territory Health Services.

This publication summarises the available information on the current health status of the people of the Northern Territory, many of the important determinants of their health status, and the health services available to them. Throughout this publication statistics are presented separately for Aboriginal and non-Aboriginal people. There are five sections which cover:

• determinants of health;
• specific health issues;
• the health of particular groups;
• health services; and
• death statistics.
  

Non-Aboriginal Territorians are in most respects at least as healthy as other Australians, but most (not all) Aboriginal people in the Northern Territory and throughout Australia have much worse social and economic circumstances, living conditions and health status than other Australians. Northern Territory Aboriginal death rates are more than three times higher than Australian rates, and life expectancy is approximately 20 years less than that of other Australians.
Australian Indigenous HealthInfoNet abstract

Enquiries about obtaining a copy of this report should be directed to Public Affairs, Social Services, Territory Health Services, PO Box 40596, Casuarina, NT 0811; ph: 899 2400; fax: 8999 2700; Internet: http://www.nt.gov.au/nths

The full report is available from the Territory Health Services site in PDF format.

Dance P, Brown R, Bammer G, Sibthorpe B (2000)
Needs for residential aged care and other services by the older Indigenous population in the ACT and Region.
Canberra: National Centre for Epidemiology & Population Health.

The ACT Office of the Commonwealth Department of Health and Aged Care commissioned researchers at the National Centre for Epidemiology and Population Health at the Australian National University to conduct an analysis of needs of older Indigenous people in the ACT and region. The aim of the research was to provide a picture of aged care needs and strategies to improve access to aged care programs and services over the next five years. Ninety eight Indigenous people aged 45 years and older were interviewed. Sociodemographic data and the physical, mental and social health problems and needs of the people interviewed are also included in the report. Fifty per cent of respondents preferred an arrangement where an existing mainstream provider of aged care 'clustered' Indigenous people together in the same facility. Thirty two per cent would prefer an Indigenous-run organisation. The report also includes twelve recommendations to improve aged care and services for Indigenous people.
Australian Indigenous HealthInfoNet abstract

Gulash A, Saunders J, White P (1999)
'Tell the story'. Barriers to effective communication in mental health assessments for Aboriginal and Torres Strait Islander Peoples. The development of culturally appropriate assessments for Aboriginal and Torres Strait Islander Mental Health Consumers.
Wacol: Queensland Centre for Schizophrenia Research.

Current mental health assessment processes have been identified by Aboriginal and Torres Strait Islander people as contributing to the over-representation of Aboriginal and Torres Strait Islander peoples in mental health facilities, including forensic facilities. This report summarises the views of Aboriginal and Torres Strait Islander project participants on how assessment processes can be modified.

The report outlines a number of recommendations which centre around making Aboriginal and Torres Strait Islander communities more aware of mental health issues in general. It summarises also specific ways to empower communities to recognise and, in time, develop methods of community self-management for mental health issues. Strategies need to be developed by Aboriginal and Torres Strait Islander people in partnership with mainstream service providers, rather than imposing mainstream methods on communities.
Australian Indigenous HealthInfoNet abstract

The full report is available in html format on the Queensland Centre for Schizophrenia Research's Internet site, or may be downloaded in word format.

Copies may also be available from the Queensland Centre for Schizophrenia Research, Wolston Park Hospital, Wolston Park Road, Wacol, Qld 4076: ph: (07) 3271 8592; fax: (07) 3271 8567; Internet: http://www.qcsr.uq.edu.au/

Matthews S, Jenkin R, Frommer M, Tjhin M, Rubin, G (2001)
When research reports and academic journals are clearly not enough. Strengthening the links between Aboriginal health research and health outcomes.
Casuarina: Cooperative Research Centre for Aboriginal and Tropical Health.

The Cooperative Research Centre for Aboriginal and Tropical Health (CRCATH) was established in 1997 as a collaborative research organisation. This paper documents the steps that were undertaken to support the development of a health-outcomes-oriented research culture. The paper is divided into three sections, which cover:

• the establishment phase of the organisation from 1997 to 1999;
• the links between Aboriginal health research, policy and practice; and
• the development phase of the organisation from 1999 to 2000.

The second section addresses the question:

'How should the CRCATH set research priorities which are likely to lead to improvements in Aboriginal health, not just increases in knowledge?'

Three main recommendations resulted from this discussion paper with the principal recommendation being that the CRCATH should divide its investment in research between:

• 'research projects and programs; and
• the development and support of models of research organisation designed to promote the implementation of research findings which are likely to lead to improvements in Aboriginal health.'

Australian Indigenous HealthInfoNet abstract

Enquiries about obtaining a copy of this report should be directed to the Cooperative Research Centre for Aboriginal and Tropical Health, PO Box 41096, Casuarina, NT 0820; Internet: http://www.crcah.org.au

New South Wales Health (2000)
From the ground up. Summary NSW Aboriginal health regional plans.
December 2000.

This report was developed by the New South Wales Aboriginal Health Forum to inform funding, policy development and service development and administration processes in NSW. It provides a summary of the seventeen Aboriginal Health Regional Plans for NSW and links these to the NSW Aboriginal Health Strategic Plan. The summary is divided into ten sections. The first section provides a background to the regional planning process and places the regional plans in the context of other Aboriginal health planning processes occurring in NSW. The Population Overview in Section 2 provides regional comparisons of household income, occupation, unemployment and school leaving age. Section 3 is the Health Overview which contains a brief summary of hospitalisation data for NSW and an estimate of overall expenditure on Aboriginal health in NSW. The key issues for NSW are outlined in Section 4, with these issues being discussed in greater detail in the next five sections. Section 10 provides a summary of the major issues by region.
Australian Indigenous HealthInfoNet abstract

Ogilvie E, Van Zyl A (2001)
Young Indigenous males, custody and the rites of passage.
Canberra: Australian Institute of Criminology.

The over-representation of Indigenous people in Australian prisons and detention centres is well documented, with the Indigenous prison population growing faster than the non-Indigenous prison population. This paper examines the concept of incarceration as an alternative 'rite of passage' for young Indigenous males in the Northern Territory. Both anthropological and criminological concepts of rites of passage are discussed in related to young Indigenous' males experiences of incarceration in the Northern Territory. Interviews were conducted with incarcerated juveniles and adults, custodial staff and judicial officials over a period of six months. These interviews were aimed at identifying the background factors related to the imprisonment of the interviewees. The interviews point to detention being seen by the young people as an opportunity for a different experience from that available in the remote communities. While there may be issues of status associated with incarceration, the adolescent criminality in the Northern Territory is primarily born out of boredom, resulting from marginalisation and lack of access to resources.
Australian Indigenous HealthInfoNet abstract

Thomson N, Irvine J (2001)
A review of cancer among Aboriginal people in Western Australia.
Perth: Cancer Foundation of Western Australia.

This review was undertaken by the Australian Indigenous HealthInfoNet for the Cancer Foundation of Western Australia to assist the Foundation in planning its activities with Indigenous communities in WA.

In the five-year period 1993-1997, the age-standardised incidence rate for cancer was significantly lower for Indigenous than non-Indigenous males but the rate for Indigenous females was slightly higher than that for non-Indigenous females. Age-standardised death rates were higher for Indigenous than non-Indigenous people.

The most common specific cancers among Indigenous people were also the most common among non-Indigenous people but comprised smaller proportions of all cancers - prostate cancer for males, and breast cancer for females. Of other specific cancers, incidence and death rates for lung cancer were much lower for Indigenous than non-Indigenous males, but the rates were similar for Indigenous and non-Indigenous females. Incidence and death rates for cervical cancer were much higher for Indigenous than non-Indigenous females. Incidence and death rates for liver cancer were much higher for Indigenous than non-Indigenous people. Incidence and death rates for pancreatic cancer were much higher for Indigenous than non-Indigenous people.
Australian Indigenous HealthInfoNet abstract

Enquiries about obtaining a copy of this report should be directed to the Cancer Foundation of Western Australia Inc, 46 Ventnor Avenue, West Perth, WA 6005; ph: (08) 9212 4333; fax: (08) 9212 4334.

The Tiwi Health Board (2001)
The Tiwi Health Board story.
Stuart Park: Tiwi Health Board.

The Tiwi Islands, Bathurst and Melville, are located sixty kilometres north of Darwin. The Tiwi Health Board was created in 1996 to empower Tiwi people to improve health by taking control of service delivery. This document summarises the aims and achievements of the Tiwi Health Board and its programs.
Australian Indigenous HealthInfoNet abstract

Enquiries about obtaining a copy of this report should be directed to the Tiwi Island Health Board, Bishop Street, Stuart Park, NT 0811; ph: (08) 8941 5331.

Trudgen R (2000)
Why warriors lie down and die. Towards an understanding of why the Aboriginal people of Arnhem land face the greatest crisis in health and education since European contact.
Darwin: Aboriginal Resource and Development Services Inc.
View book review

Youth Suicide Advisory Committee (2000)
Working together to stop Aboriginal suicide and self-harm in Western Australia.
Perth: Youth Suicide Advisory Committee.

The rate of suicide among WA Aboriginal youth is double that of their non-Aboriginal counterparts. The WA Youth Suicide Advisory Committee in consultation with a range of Aboriginal individuals, groups and organisations developed a number of recommendations for policy and programs to prevent suicide and suicidal behaviour among Aboriginal youth in Western Australia. This report outlines these recommendations and overall goals and strategies for prevention.

The four overall goals proposed to prevent Aboriginal youth suicide were:

• to prevent both fatal and non-fatal suicidal behaviour among Aboriginal people aged 25 years or less;
• to reduce the impact of suicide and suicidal behaviour on individuals, families and communities;
• to improve access and availability of appropriate prevention services for vulnerable youth groups and high-risk individuals; and
• to encourage the development of Aboriginal family and community networks to support young people at risk and to promote their resilience and emotional wellbeing.

Australian Indigenous HealthInfoNet abstract

Enquiries about obtaining a copy of this report should be directed to the Health Department of WA, PO Box 8172, Perth Business Centre, Perth, WA 6849; ph: (08) 9222 4222; fax: (08) 9222 4046.

Last updated: 12 February, 2002