Introduction

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Overview of the health of Indigenous people in Western Australia 2011    Introduction    Population structure    Births and pregnancy outcome    Mortality    Hospitalisation    Selected health conditions       Cardiovascular health       Cancer       Diabetes       Social and emotional wellbeing (including mental health)       Kidney health (renal disease)       Injury       Respiratory disease       Communicable diseases          Sexually transmitted infections          Hepatitis          HIV/AIDS          Other communicable diseases       Eye health       Ear health       Oral health    Health risk factors    Concluding comments

This overview 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)1.

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 for which the identification of Indigenous mothers and fathers is considered good [1][2]. As noted below, reasonably reliable information is available for Western Australia (WA) for some other administrative collections, but there is substantial room for improvement:

• the estimated coverage of Indigenous births in WA was 94% for the period 2000-2004 [3]
• the coverage of Indigenous people in death registrations in WA is likely to be between ABS’s estimate of 72% for the period 2000-2004 [3] and their estimate of 92% based on a study linking deaths in 2006-2007 with 2006 census information [4]
• assessment of the quality of identification of Indigenous people in data from 26 hospitals in WA, in 2000, found that the official statistics understated the actual number of Indigenous people admitted as patients and the level of accuracy varied between regions [5]. The areas with the highest proportion of Indigenous people had the highest level of accuracy in the recording of Indigenous status.

The need for information at a community level was identified in consultations undertaken for the development of the National Aboriginal and Torres Strait Islander information plan [6], but there are no reliable data routinely available at this level. Survey information, particularly that collected nationally by the Australian Bureau of Statistics (ABS), such as the 2004-05 National Aboriginal and Torres Strait Islander health survey (NATSIHS), is valuable, but it is limited at a regional level by the relatively small number 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. On the other hand, very good data about various aspects of the health of Indigenous children in WA is available from the Western Australian Aboriginal child health survey (WAACHS).

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, hospital statistics relate to episodes of hospitalisation, with the result that each admission of an individual for a specific condition will be counted. This has a major impact on the numbers of admissions for aspects like renal dialysis, for which some people may be admitted many times in a year.

As well, the comparability of hospitalisation statistics is limited by many factors, including regional variations in admission practices, 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.

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.

References

1. Australian Bureau of Statistics, Australian Institute of Health and Welfare (2006) Recent developments in the collection of Aboriginal and Torres Strait Islander health and welfare statistics. Canberra: Australian Bureau of Statistics and Australian Institute of Health and Welfare
2. Thomson N (2003) The impact of health on the education of Aboriginal children. In: Beresford Q, Partington G, eds. Reform and resistance in Aboriginal education: the Australian experience. Perth: University of Western Australia Press: 110-132
3. Australian Bureau of Statistics, Australian Institute of Health and Welfare (2005) The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples 2005. Canberra: Australian Institute of Health and Welfare and the Australian Bureau of Statistics
4. Australian Bureau of Statistics (2008) Indigenous mortality quality study, 2006-07 - information paper: census data enhancement. Canberra: Australian Bureau of Statistics
5. Young MJ (2001) Assessing the quality of identification of Aboriginal and Torres Strait Islander people in Western Australian hospital data, 2000. Perth: Health Department of Western Australia
6. Aboriginal and Torres Strait Islander Health and Welfare Information Unit (1997) The Aboriginal and Torres Strait Islander health information plan. Canberra: AHMAC, AIHW & ABS

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