The July 2023 release incorporates updates from the following measures: 1.10 Kidney disease; 2.01 Housing; 2.05 Education outcomes for young people; 2.06 Educational participation and attainment of adults; 2.07 Employment; 2.08 Income; 2.12 Child protection; 3.02 Immunisation; 3.12 Aboriginal and Torres Strait Islander people in the health workforce; 3.13 Competent governance; 3.20 Aboriginal and Torres Strait Islander people training for health-related disciplines; 3.21 Expenditure on Aboriginal and Torres Strait Islander health compared to need; and 3.22 Recruitment and retention of staff.
In 2018, the burden of disease among Aboriginal and Torres Strait Islander people was 2.3 times that of non-Indigenous Australians. Among Indigenous Australians, mental and substance use disorders were the leading contributor to disease burden (24%).
Measures of health status, determinants of health, and health system performance drawn from the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) show mixed results. It is important to note that measures in the 3 tiers are interconnected, and understanding the reasons for progress (or lack thereof) in the health status and outcomes of Indigenous Australians may often be best understood by examining relevant measures in determinants of health and health system performance.
Analysis by the AIHW of ABS survey data indicates that about 34% of the total health gap between Indigenous and non-Indigenous Australians is due to social determinants, and 19% due to individual health risk factors (e.g. smoking). It is likely that differences in access to affordable and nearby health services explain a significant proportion of the health gap between the Indigenous and non-Indigenous populations. In many cases, Indigenous Australians have poorer access to health services than non-Indigenous Australians, for a range of reasons including barriers such as availability, cost and a lack of culturally appropriate health services. For Indigenous Australians to have better health outcomes, improvements in the health system are required.
For Indigenous Australians, cultural identity, family and kinship, country and caring for country, knowledge and beliefs, language and participation in cultural activities and access to traditional lands are also key determinants of health and wellbeing.
Across the HPF measures, there have been notable improvements in many areas – for example, increases in rates of Year 12 attainment, employment and home ownership, and decreases in rates of cardiovascular mortality, smoking, youth detention, and overcrowding.
However there has been little progress in other measures, and some have worsened. For example, there has been no significant change in the rate of avoidable mortality, and both adult imprisonment rates and suicide rates have increased.
Over the decade from 2010 to 2019, the rate of avoidable deaths among Indigenous Australians did not change significantly, nor did the gap between Indigenous and non-Indigenous Australians.
Between 2010 and 2019, there was no significant changes in perinatal death rates for babies born to Indigenous mothers, nor in Indigenous infant death rates.
Over the decade 2010 to 2019, the rate of death due to cardiovascular disease and kidney disease for Indigenous Australians decreased by 18% and 36%, respectively.
The proportion of Indigenous Australians aged 15 and over who smoke daily fell from 45% in 2008 to 37% in 2018–19.
Smoking accounted for 47% of the burden of disease due to respiratory disease, 37% of the burden of disease due to cancer and 34% of the burden due to cardiovascular disease in 2018.
For Indigenous Australians aged 25–64, the employment rate increased from 51% in 2006 to 56% in 2021.
The proportion of Indigenous Australians aged 25–64 who were employed increased with level of educational attainment, reaching 85% of those whose highest level of education was a bachelor’s degree
From 2011 to 2021, the proportion of Indigenous Australians aged 20–24 who had completed year 12 or equivalent increased from 52% to 68%. The gap in attainment rates between and Indigenous and non-Indigenous Australians also decreased, from 34 to 23 percentage points.
Between 2011–12 to 2020–21, the rate of Indigenous young people aged 10–17 years under youth justice supervision fell from 186 to 117 per 10,000 population between 2011–12 to 2020–21, with a 30% decline in community supervision and a 25% decline in detention.
In 2018–19, 3 in 10 Indigenous Australians who needed to go to a healthcare provider did not. Barriers included cost, and health services being unavailable, far away or with long waiting times.
Between 2011 and 2021, the rate of Indigenous Australians aged 15 and over employed in health-related occupations increased from 255 to 309 per 10,000.
In 2021, Indigenous Australians were employed in health-related occupations at about 60% the rate of non-Indigenous Australians (309 compared with 515 per 10,000).