Australian Indigenous

Overview of Indigenous health 2004

This overview is also available as a downloadable PDF using Adobe Acrobat.

• Preface
• Acknowledgments
• Introduction
  • Limitations of the sources of Indigenous health information

Preface

This overview has been prepared by the Australian Indigenous Health InfoNet as a part of our efforts to contribute to improvements in Indigenous health by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians, researchers and the general community.

Research for the overview involved the collection, collation, and analysis of a wide range of relevant information, including both published and unpublished material. Sources included government reports, articles in journals and other periodicals, books and book chapters, reports from specific studies and projects, and dissertations and theses.

The overview draws on information from the main administrative data collections (such as the birth and death registration systems and the hospital inpatient collections) and national surveys. Information from these sources has been published mainly in government reports, particularly those produced by the Australian Bureau of Statistics (ABS) and the Australian Institute of Health and Welfare (AIHW).

Importantly, the overview draws also on a wide variety of other information sources, including registers for specific diseases and other conditions, regional and local surveys, and numerous epidemiological and other studies examining particular diseases, conditions, and health determinants. Information from these sources is disseminated mainly through journals and similar periodicals, or in special reports (such as the annual reports of the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA)).

A number of sections include the results of our own analyses of data obtained from a variety of sources. For example, detailed information about mortality for a number of conditions was derived from information obtained from the AIHW Mortality Database. Similarly, estimates of the age-adjusted incidence of end-stage renal disease were made using notification data provided by ANZDATA.

The initial sections provide information about the Indigenous population, the context of Indigenous health, and various measures of population health status. Most sections about specific health conditions comprise an introduction about the condition and evidence of the current burden of the condition among Indigenous people. A final section summarises the current details about expenditure for Indigenous health. (To assist readers who may not be familiar with some of the technical aspects about the analysis of health data, a glossary is provided.)

Further information about the aspects summarised in this overview are included in the corresponding sections of the Health InfoNet 's website (www.healthinfonet.ecu.edu.au).

We welcome your comments and feedback about the overview.

Neil Thomson, Director, on behalf of the Health InfoNet team

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Acknowledgments

Particular thanks are extended to:

• the Australian Institute of Health and Welfare, which provided some of the mortality data used in the special analyses included in this overview. Krys Sadkowsky and Paul Jelfs were particularly helpful in the provision of these data;

• the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), which provided data on new cases of end-stage renal disease. We are particularly grateful to Stephen McDonald for the provision of these data, and for his advice in its analysis;

• the Western Australian Cancer Registry for details of cancer incidence and mortality in that State. We are extremely grateful to Dr Tim Threlfall, the Registry's Senior Medical Officer, who provided expert guidance in the selection of cancers to be analysed, and, most importantly, extracted and analysed data from the Cancer Registry's database;

• other staff of the Australian Indigenous Health InfoNet for their support and encouragement in the preparation of this overview; and

• the anonymous reviewers of this overview for their constructive comments.

Finally, special thanks are extended to the Office for Aboriginal and Torres Strait Islander Health within the Australian Department of Health and Ageing for the support that enabled expansion of the Health InfoNet 's previous Overview of Indigenous health to this form and the funds for production and distribution of a hard-copy version.

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Introduction

This overview of Australian Indigenous health draws largely on published information, some of which has been re-analysed to provide clearer comparisons between Indigenous and non-Indigenous people (for more details of statistics and methods, readers should refer to the original sources). Very little information is available separately for Australian Aboriginal people and Torres Strait Islanders, so no attempt has been made to provide separate summaries for these two sub-groups of the Indigenous population. In addition to information about health status, this overview includes a brief paragraph about health expenditure on Indigenous health.

Limitations of the sources of Indigenous health information

Indigenous health information is limited by relatively low levels of identification of Indigenous people in the vital statistics and administrative data collections, except those relating to births (in most jurisdictions) and to deaths in the Northern Territory (NT) [1]¹. In other administrative collections, reasonably reliable information is available for Western Australia (WA), South Australia (SA) and the NT, but there is substantial room for improvement. Also, the need for information at community level was identified in consultations undertaken for the development of the National Aboriginal and Torres Strait Islander Information Plan [2]². Survey information, such as that collected nationally by the Australian Bureau of Statistics (ABS), for example, the 2001 National Health Survey (NHS), is valuable, but it is limited by the relatively small numbers of Indigenous people surveyed. It is also difficult to compare survey findings because of differing sample sizes, methodologies and seasonal variations in some health conditions.

Statistics on hospitalisation provide some insights into ill-health in the population. They are, however, quite a poor reflection of the extent and patterns of treatable illness in the community, since they represent only illness that is serious enough to require hospitalisation. Even then, the comparability of hospitalisation statistics is limited by many factors, including State/Territory and regional variations in admission policies, and differential geographic accessibility of hospitals. Importantly, the incompleteness of Indigenous identification in most jurisdictions means that comparisons of Indigenous and non-Indigenous hospitalisation, including those presented in this overview, under-estimate the true difference.

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Last updated: 12 January, 2005