Introduction
Preface
This overview has been prepared by the Australian Indigenous HealthInfoNet as a part of our efforts to contribute to improvements in Australian 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involved the collection, collation, and analysis of a wide range of relevant information, including both published and unpublished material.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, and reports from specific studies and projects.
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, estimates of the age-adjusted incidence of end-stage renal disease were made using notification data published by ANZDATA. Similarly, information about a number of communicable diseases was derived from data published by the National Centre for HIV Epidemiology and Clinical Research.
The initial sections provide information about the Indigenous population 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.
Further information about the aspects summarised in this overview are included in the corresponding sections of the HealthInfoNet 's website (view health topic index) on which updated versions of this overview will be made available.
We welcome your comments and feedback about the overview.
Neil Thomson, Director, on behalf of the HealthInfoNet team
Acknowledgments
Particular thanks are extended to:
- Professor Peter McIntyre, Director of the National Centre for Immunisation Research and Surveillance, for his helpful comments in the preparation of the relevant sections related to communicable diseases;
- other staff of the Australian Indigenous HealthInfoNet for their support and encouragement in the preparation of this overview; and
- the Office for Aboriginal and Torres Strait Islander Health (OATSIH) within the Australian Department of Health and Ageing for their ongoing support of the work of the HealthInfoNet
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 population1
Limitations of the sources of Indigenous health information
The assessment of Indigenous health status requires accurate information about the size of the population and the numbers of specific health conditions/occurrences. This information is required at national, regional, and local level (for more information about the assessment of population health status, see [1].
There have been some improvements in recent years – both in estimates of the Indigenous population (the denominator for calculation of rates) and in the availability of data for a number of health conditions/occurrences (the numerators) – but there is still some uncertainty in most areas.
The Australian Bureau of Statistics (ABS) and the Australian Institute of Health and Welfare (AIHW) have been working with State and Territory authorities in recent years to improve the accuracy of Indigenous status in a number of health-related collections, including birth and death registrations, hospital administrative data, and the maternal/perinatal collection. Attention has been directed also to the data collections related to communicable disease, cancer and a number of other disease-specific collections. Indigenous people are not accurately identified in many of these collections, however, because of differences in the definitions used for Indigenous identification, and the failure, in many cases, to record a client’s Indigenous status.
As a result, even for something as basic as mortality information, only 57% of projected Indigenous deaths were identified in 2000-2004 [2]. The level of identification was so low for most jurisdictions that the ABS’s estimates of age-specific death rates in 2000-2004 were based only on the combined data from Qld (53% identification of projected deaths, WA (72%), SA (66%), and the NT (94%).
At 94%, the implied identification of Indigenous births was much better in 2000-2004 [3], but the level of identification in hospital admissions is very variable, with the overall level unlikely to be better than for deaths [4].
With these uncertainties, there must be some doubt about the precision of the various estimates of Indigenous health status. The differences between Indigenous and non-Indigenous people in the levels of most of these estimates are so great, however, that the slight imprecision in some estimates is of little importance.
References
1 Thomson N(2003) The need for Indigenous health information. In: Thomson N, ed. The health of Indigenous Australians. South Melbourne: Oxford University Press:1-24
2 Australian Bureau of Statistics (2005) Deaths Australia, 2004. (ABS catalogue no. 3302.0) Canberra: Australian Bureau of Statistics
3 Australian Bureau of Statistics (2005) Births Australia, 2004. (ABS catalogue no. 3301.0) Canberra: Australian Bureau of Statistics
4 Australian Institute of Health and Welfare (2006) Australian hospital statistics 2004-05. (AIHW catalogue no. HSE 41) Canberra: Australian Institute of Health and Welfare
Endnotes
1 The term ‘Indigenous’ is used in this overview to
refer generally to the two Indigenous populations of Australia –
Australian Aboriginal people and Torres Strait Islanders.
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