An electronic publication from the Australian Indigenous HealthInfoNet
Issue 7, May 2000: ISSN 1329-3362
Reports and publications
Brady, M., & Martin, D.F. (1999).
Dealing
with alcohol in Alice Springs: an assessment of policy options and recommendations
for action. Centre for Aboriginal Economic Policy Research, Australian
National University, CAEPR Working Paper No. 3/1999.
This report was prepared for a working group made up of: Richard Preece, the Regional Manager of the Aboriginal and Torres Strait Islander Commission (ATSIC), Alice Springs office; John Elferink MLA (Country Liberal Party (CLP); Peter Toyne MLA (Australian Labor Party); Garry Stoll (Lutheran Church); and Bernie Kilgariff (retired Northern Territory CLP Senator). The authors are anthropologists with many years of experience working with Indigenous Australians and both have carried out major work relevant to the issue of substance abuse.
This report was written from the perspective of minimising the damaging impact of alcohol abuse on the Alice Springs Aboriginal community, but it has wider relevance. It is important to recognise that while social misbehaviour is more obvious among homeless and transient Aboriginal people in Alice Springs, high levels of alcohol consumption are very common in many parts of the Alice Springs community. The extremely high levels of alcohol consumption, even by Northern Territory standards, demonstrated by the consumption figures quoted in the report, is an issue for all in the Alice Springs community.
The report's recommendations are intentionally restrained. This is because in order to implement change the working group and the authors felt that change strategies are more likely to be adopted if they are politically sustainable and incremental, but can be practically applied. The strategies proposed here are not intended as a critique of other different approaches supported by ATSIC or any other agency.
Indigenous drinking patterns are, in the main, those of opportunistic drinkers, and contrast with the behaviour of mainstream heavy drinkers. The report proposes that the most successful strategies must include a focus on the supply issue. Strategies such as wet canteens in bush communities and attempts to remove people from Alice Springs back to their communities will almost certainly be unsuccessful and likely to be counterproductive. Education and other programs are important, but are unlikely to be successful while the supply issue is not addressed.
The report proposes a strategy which, most importantly, seeks to encourage a responsible server culture. It also proposes that: existing programs are supported and enhanced; high risk consumption and sales practices are targeted; changes in licenses and hours of sale are considered; activities of relevant government agencies are coordinated; and that an information database from which informed decisions can be made is developed.
While this is a somewhat different research project for the Centre for Aboriginal Economic Policy Research (CAEPR), we are keen to see it electronically published to facilitate widespread dissemination and transparency. It is self-evident, we believe, that 'dealing with alcohol' is an important precursor to facilitating economic development options for Indigenous Australians.
Foreword by Professor Jon Altman, Director, CAEPR & Richard Preece, Regional Manager, ATSIC, Alice Springs (October 1999). Reproduced with the permission of CAEPR.
This
paper
is available from the CAEPR Website as an Adobe Acrobat pdf file. Click
here to download Adobe
Acrobat Reader.
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Chan, A., Scott, J., McCaul, K., & Keane, R. (1999). This review summarises the perinatal and abortion statistics collection
of South Australia. The in-depth compilation covers a wide range
of statistics derived from the notification of birth records. The
report compares statistics for Aboriginal and non-Aboriginal women
and highlights significant epidemiological perinatal data that relate
to Aboriginal women. Aboriginal mothers accounted for 2.2% of all
confinements and were often young, with 21.1% being teenagers. The
perinatal mortality rate for Aboriginal mothers was 28.8 per 1,000
total births compared with 8.5 for non-Aboriginal mothers. The report
highlights the fact that Aboriginal women had fewer antenatal visits
than other women and that they had a greater proportion of low birthweight
births. |
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Craze, L., & Lucas, S. (1998). This document reports on the development and implementation of
a pre-hospital ambulance care service for remote Aboriginal and
Torres Strait Islander communities on Mornington Island and in Doomadgee.
The project included funding, structure, staff recruitment and training
and used community consultative processes to ensure compatibility
with Aboriginal cultural beliefs and practices. The report provides
recommendations for funding, models, guidelines, training and government
involvement. Enquiries about obtaining copies of this report should be directed to: The Queensland Ambulance Service, Level 3, Warrian Wing, Corner Park Road and Kedron Park Road, Kedron, QLD, 4031. Ph: 07 3247 8200; Fax: 07 3247 8210. |
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Cunningham, J. & Paradies, Y. (2000).
Mortality
of Aboriginal and Torres Strait Islander Australians, 1997.
Australian Bureau of Statistics Occasional paper. Catalogue no. 3315.0.
ABS, Canberra. ISBN 0 642 274967.
This report examines the mortality of Indigenous Australians in the three-year period 1995-1997.
After considering the reliability of information about Indigenous deaths for each jurisdiction, the report focuses on those occurring in Western Australia (WA), South Australia (SA) and the Northern Territory (NT). Australia-wide, the ratio of registered to expected deaths was only 0.49 for 1997. For WA, SA and the NT respectively the ratios were 0.70, 0.68 and 1.00, based on year of registration, and 0.88, 0.75 and 0.71, based on year of occurrence.
For WA, SA and the NT combined, the Indigenous SMRs (standardised mortality ratios - the ratios of the numbers of deaths observed to the numbers expected from total Australian population age-specific death rates) were 3.0 for both males and females. For these jurisdictions separately, the SMRs were: WA - males 2.9, females 2.9; SA - males 2.9, females 2.3; and the NT - males 3.3, females 3.6.
Much higher proportions of all deaths occurred to people aged less than 50 years for Indigenous people (males 53%, females 41%) than for non-Indigenous people (males 13%, females 7%). Death rates for Indigenous people in WA, SA and the NT combined were higher than those for the total Australian population for all age groups, particularly for people aged 25-54 years. For infants (aged less than 1 year), the death rate for Indigenous males was 3.1 times that for all Australian males, and the rate for Indigenous females was 3.5 times that for all Australian females [it should be noted these are not ratios of infant mortality rates, even though the values of the ratios would be similar].
The leading causes of death for Indigenous people were cardiovascular disease (including heart attack and stroke), injury (including motor vehicle traffic crashes, homicide and suicide), cancer and respiratory disease, also the leading causes for the total Australian population. The SMRs were: cardiovascular disease - males 2.9, females 2.5; injury - males 3.2, females 3.5; cancer - males 1.4, females 1.4; respiratory disease - males 5.2, females 6.0. The SMRs for three specific causes warranting special mention were diabetes - males 8.9, females 16.2; chronic liver disease and cirrhosis - males 6.7, females 13.0; and genitourinary disease (mainly kidney disease) - males 6.7, females 7.9.
The report concludes that, because of data quality issues, the reported differences between Indigenous and all-Australian mortality are under-estimates of the true differences.
Australian Indigenous HealthInfoNet abstract
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The report is available as a pdf. Click here to download Adobe Acrobat Reader. |
Copies of this report (RRP $22.00) are available from ABS bookshops in
capital cities or from the national mail order service: telephone: (02)
6252 5249 or 1 800 02 0608. The report should be available also from Commonwealth
Government Info Shops and agents in every capital city and Townsville.
Orders can be placed by telephone (132 447 toll-free 24-hour service),
mail order (Mail Order Sales, AusInfo, GPO Box 84, Canberra, ACT 2601).
Specific inquiries about the report should be directed to Dr Joan Cunningham,
Telephone: (08) 8943 2165.
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Day, P., Sullivan, E.A., Ford, J., & Lancaster, P. (1999). Australia's mothers and babies 1997 provides information
on births in Australia from perinatal data collections for each
State and Territory. The report examines demographic and pregnancy
factors of mothers and the characteristics and outcomes of their
babies. This report will be particularly useful to consumers of
perinatal health care services, perinatal health service planners
and those providing services or conducting research in reproductive
and perinatal health. The report was produced by the AIHW National
Perinatal Statistics Unit based at the University of New South Wales.
Enquiries about obtaining copies of this report should be directed to: the Australian Institute of Health and Welfare, GPO Box 570, Canberra, ACT, 2601 or the Institute's Website at http://www.aihw.gov.au. |
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Hunter, B. (1999).
Centre for Aboriginal Economic Policy Research, Australian National University,
CAEPR Working Paper No. 1/1999.
Benjamin Disraeli originally coined the phrase 'Two Nations' in 1845 to characterise the chasm between rich and poor in Victorian England. While the differential in access to resources has been reduced this century by the development of the welfare state, there is ongoing concern about the level of inequality in Australia. This paper attempts to develop, and sustain, the metaphor that there are three Nations in Australia: the rich, the poor non-Indigenous Australians and Indigenous Australians. That is, Indigenous Australians are different from other poor and rich Australians in the nature and extent of destitution experienced in much of their community.
The paper is written in six sections. First, a discussion of several case studies and personal accounts in order to illustrate the Indigenous experience of poverty. Second, an introduction of several conceptual and empirical issues for measuring the multi-faceted nature of Indigenous poverty. Third, a description of the data and method used to analyse Indigenous poverty. Fourth, a presentation of data which illustrates the multi-dimensional nature of Indigenous poverty. The penultimate section canvasses strategies for tackling Indigenous poverty while the final section provides some concluding remarks.
Summary from Working Paper reproduced with the permission of CAEPR.
Senate Employment, Workplace Relations, Small Business and Education
References Committee. (2000).
Katu
Kalpa - Report on the inquiry into the effectiveness of education and
training programs for Indigenous Australians.
Report of the Senate Employment, Workplace Relations, Small Business and
Education References Committee, March 2000.
The report notes the complex inter-relationships involved in addressing Indigenous educational needs. It notes that factors such as health, social and community development, and the diverse nature of Indigenous populations have a major impact on levels of educational participation and achievement in Indigenous communities, and in turn influence the educational levels of Indigenous peoples. The report devotes a chapter to 'The impact of health on education', in which attention is directed to aspects such as barriers to adequate health care and the health problems of Indigenous Australians (including a major section on otitis media and hearing loss).
The Committee concludes that there is a need for holistic approaches involving action across a range of areas: 'educational improvements on their own stand little chance of success without improvements in health care, social and community well-being, and general living conditions. Progress in all areas depends fundamentally on the involvement of Indigenous communities. However, the support of government agencies working cooperatively to provide an appropriate and sensitive 'whole of government' approach is essential to this process.'
Australian Indigenous HealthInfoNet abstract
The report
is available electronically on the Senate's Website
Copies of the report are available from the Commonwealth Government Info
Shops and agents in every capital city and Townsville. Alternatively,
orders can be placed by telephone (132 447 toll-free 24-hour service),
mail order (Mail Order Sales, AusInfo, GPO Box 84, Canberra, ACT 2601).
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South Australian Health Commission. (1999). This report covers statistics for maternal, perinatal and infant mortality in South Australia for 1998, and SIDS prevention methods. In summary, there were three neonatal deaths of infants of Aboriginal
mothers, resulting in an infant mortality rate for babies of Aboriginal
mothers nearly twice that for babies of non-Aboriginal mothers (7.4
compared with 3.9 per 1,000 livebirths), but a considerable improvement
over previous years. There were no deaths from sudden infant death
syndrome (SIDS) of babies of Aboriginal mothers in 1998. The SIDS
infant mortality rate for babies of Aboriginal mothers for 1991-1998
was 2.8 compared with 0.7 per 1,000 livebirths for babies of non-Aboriginal
mothers. |
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Taylor, J. (1999).
Centre for Aboriginal Economic Policy Research, Australian National University,
CAEPR Working Paper No. 4/1999.
In 1996, the Kakadu Region Social Impact Study (KRSIS) was established by a range of parties, including the Commonwealth and Northern Territory Governments, to determine the social impact of development on Aboriginal communities in the Kakadu region. This study was deliberately structured (via an Aboriginal Project Committee) to ensure Aboriginal control of key aspects of the research process and to maximise involvement of the Aboriginal community. The overall study aimed to provide a clear statement of Aboriginal experiences, values and aspirations in relation to mining, tourism and other developments in the region. It also aimed to develop an Action Plan to address any negative impacts associated with these developments. However, despite two major previous social impact studies in the region (the Fox Inquiry, completed in 1977, and the Social Impact of Uranium Mining study, 1984) when faced with the task of profiling the employment, income, education, housing and health status of the Kakadu Aboriginal population in 1996 and of providing some analysis of how these might have changed over the previous 20 years, the KRSIS quickly found an absence of readily available and comprehensive information.
Hence in June 1996, as the project began, the Northern Land Council approached Dr John Taylor to provide the Aboriginal Project Committee of KRSIS with a statistical profile of the Aboriginal population of the region with a view to reviewing all existing information to establish trends in social and economic status. This report was completed and submitted to the KRSIS in October 1996 and has formed the basis of much subsequent deliberation both by the Aboriginal Project Committee and by the Study Advisory Group, of which I was a member.
There are four important reasons for publishing this report in the CAEPR Working Paper series. First, while copies of Dr Taylor's original report are available on request 'in writing from the Environmental Research Institute of the Supervising Scientist in Jabiru, this is a cumbersome and sub-optimal mode of dissemination of important benchmark data. Also, it is not clear if this service will always be available. Second, as already noted, a major criticism of previous studies was their failure to generate a comprehensive and publicly accessible database. This potential problem is addressed here by providing free Internet access to the report as a CAEPR Working Paper. Third, the original report was completed well before the release of 1996 Census data. As there are major deficiencies in these data for the Kakadu region, an analysis has been made of these and included here for the record. Finally, the issue of the socioeconomic status of Aboriginal people in Kakadu remains of political, economic, cultural and policy relevance, as demonstrated, for example, by the UNESCO Kakadu Mission a year ago. The sort of quantitative and impartial research reported by Dr Taylor might facilitate informed debate on important development issues in this high profile region.
Foreword by Professor Jon Altman, Director, CAEPR (November 1999). Reproduced with the permission of CAEPR.
As well as reinforcing 'what is already known: that heart disease and stroke, diabetes, respiratory diseases, cancer and injury are the most significant contributors to Aboriginal and Torres Strait Islander ill health and death', the report provides useful information also about a variety of health and health-related indicators.
The report comments on some of the problems and shortcomings of the current set of performance indicators. These include lack of the necessary processes to collect relevant data; poor quality of some data; the appropriateness of some of the indicators; the lack of indicators for emotional and social well-being; and the need for targets for each indicator.
The report concludes that 'it is important now to take stock and collaboratively work out a more strategic approach to future reporting. Such an approach should enable stakeholders to form a national picture of the comprehensive and systematic approaches to health status improvement being undertaken across the country, and where gaps in the overarching system exist so that resources can be targeted more effectively in the policy context'.
Australian Indigenous HealthInfoNet abstract
For copies of this report, contact: Publications Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra, ACT 2601. Telephone: 02-6244 1111, or order it through the AIHW Website at http://www.aihw.gov.au.
The report may be available also from Commonwealth Government Info Shops and agents in every capital city and Townsville. Orders can be placed by telephone (132 447 toll-free 24-hour service), mail order (Mail Order Sales, AusInfo, GPO Box 84, Canberra, ACT 2601).
