Aboriginal and/or Torres Strait Islander peoples’ health
7-minute read
Key facts
- For many Aboriginal and/or Torres Strait Islander people, being healthy involves physical, social, emotional and cultural wellbeing of the individual and community.
- There is a health gap between Indigenous Australians and non-Indigenous Australians.
- There are many barriers to improving the health of Aboriginal and Torres Strait Islander people due to the impacts of colonisation.
- Health policies now adopt an approach that uses the experience and knowledge of the community to develop solutions and policies for local health issues.
- National Agreement on Closing the Gap encourages governments to work together with these organisations to make culturally appropriate healthcare decisions and policies.
Who are the Aboriginal and/or Torres Strait Islander people of Australia?
Aboriginal and/or Torres Strait Islander people are the first people of Australia and the Torres Straits. They have lived in Australia and the Torres Straits for more than 60,000 years.
There are many different Aboriginal and/or Torres Strait Islander groups across Australia.
Each group has their own:
- culture
- language
- beliefs
- practices
The Aboriginal and/or Torres Strait Islander concept of good health goes beyond physical health and wellbeing. It includes both individual and community wellbeing, including:
- social
- emotional
- cultural
As of 2021, approximately 1 in 25 Australians identifies as Aboriginal and/or Torres Strait Islander. The number isn't exact because not everyone completes the Census or answers the question on Indigenous status.
The Aboriginal and/or Torres Strait Islander population is generally younger than the non-Indigenous population. This is due to higher birth rates and lower life expectancy.
Most Aboriginal and/or Torres Strait Islander people live in non-remote areas (major cities and regional areas). Around 1 in 7 First Nations people live in remote areas.
How is the health of Aboriginal and/or Torres Strait Islander people?
Life expectancy is often used to show the overall health of the Aboriginal and/or Torres Strait Islander population. While life expectancy has improved over time, there is still a wide gap compared to non-Indigenous populations.
Generally, Aboriginal and/or Torres Strait Islander people living in major cities have a longer life expectancy than those in remote areas.
There is a gap in health outcomes between Aboriginal and/or Torres Strait Islander people and other Australians. The most important areas of health concern are:
- heart disease
- diabetes
- lung and airway conditions, such as asthma and chronic obstructive pulmonary disease (COPD)
- cancers
- self-harm, mental health and substance use disorders
The impact of colonisation
Colonisation continues to have negative effects on the physical and mental health of many Aboriginal and/or Torres Strait Islander people.
Colonisation has created many health problems for Aboriginal and/or Torres Strait Islander people.
The impacts of colonisation include:
- disconnection from culture, family, and Country
- violence
- disease
- poverty, food and resource insecurity
- intergenerational trauma
- marginalisation, racism and systemic discrimination
What is the approach towards Aboriginal and/or Torres Strait Islander people's health?
The health and wellbeing of Aboriginal and/or Torres Strait Islander people is often compared to those of the other Australians. This approach is called a deficit model. It places responsibility for health gaps on the affected individuals or communities.
There is now a move in policy and healthcare towards a 'strengths-based approach'. This approach focusses on the strengths, culture, and partnerships of a community. It works to improve health outcomes while respecting the strength and resilience of Aboriginal and/or Torres Strait Islander people.
A strengths-based approach uses the experience and knowledge of a community to develop solutions and policies for local health issues.
How has Aboriginal and/or Torres Strait Islander people's health improved?
Over time, there have been improvements in birth and pregnancy outcomes. These improvements are:
- more people are attending antenatal care in their first trimester or pregnancy
- fewer people are smoking during their pregnancy
- fewer babies are born small for their age
- better management of trachoma (a type of eye infection)
Better access to culturally appropriate healthcare leads to better health outcomes. There are still many barriers to healthcare access. While some areas of health have improved, others have not, and some have even worsened.
What are Aboriginal Community Controlled Health Organisations?
The National Aboriginal Community Controlled Health Organisation (NACCHO) is the peak body for Aboriginal and/or Torres Strait Islander health.
NACCHO represents 145 Aboriginal Community Controlled Health Organisations (ACCHOs) across Australia. An ACCHO is a primary healthcare service run by local Aboriginal and/or Torres Strait Islander communities.
The first ACCHO, Redfern Aboriginal Medical Service, opened in 1971. There are now over 300 clinics across Australia. They deliver holistic, comprehensive, and culturally appropriate primary healthcare services.
NACCHO:
- gives advice to the Australian Government on policy
- advocates for community developed health solutions
- improves health outcomes for Aboriginal and/or Torres Strait Islander people
What is the National Agreement on Closing the Gap?
In 2008, the Australian government launched the Closing the Gap framework, also known as the National Indigenous Reform Agreement (NIRA). It aimed to reduce the disadvantage faced by Aboriginal and/or Torres Strait Islander people by ensuring that policy and decision-making is in partnership with community-controlled peak organisations.
In 2019, the responsibility for Closing the Gap was replaced by the National Indigenous Australians Agency. The new National Partnership Agreement on Closing the Gap is signed by:
- the Coalition of Peaks
- all Australian governments
- the Australian Local Government Association
The Coalition of Peaks is a group of over 80 Aboriginal and/or Torres Strait Islander community-controlled organisations across Australia. This includes both peak and member organisations.
The National Agreement is based around needs identified by Aboriginal and/or Torres Strait Islander people. It builds on successful parts of the NIRA while strengthening and including previously excluded areas. It is an agreement between representatives of the Aboriginal and/or Torres Strait Islander people and the Australian governments.
It includes 4 priority reforms to change the way governments work with communities. The priority reforms aim to:
- Create and strengthen structures to ensure Aboriginal and/or Torres Strait Islander people are partners in decision-making at national, state and local levels.
- Develop Aboriginal and/or Torres Strait Islander community-controlled organisations to deliver Closing the Gap programs.
- Ensure all mainstream agencies:
- contribute to Closing the Gap
- improve accountability
- identify and eliminate racism
- respond to the needs of Aboriginal and/or Torres Strait Islander people
- Ensure Aboriginal and/or Torres Strait Islander people can access local information to monitor and make decisions to close the gap and drive development.
Resources and support
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