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.
Overview
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.