29 October 2004

'Deadly': Indigenous Health Today

Indigenous Australians now experience the second worst quality of life on earth, second only to China, according to a United Nations index that measures human development.1

The latest feature in the November Australian Nursing Journal, the national journal of the Australian Nursing Federation, reports that Indigenous health status in Australia lags far behind that of non-Indigenous Australians. But, other comparable countries, such as New Zealand, North America, and Canada, have made vastly different progress in improving the health of their Indigenous populations.

In North America and New Zealand, the life expectancy gap between Indigenous and non-Indigenous people has decreased over the last couple of decades to around five to seven years. In Australia, life expectancy at birth is 56 years for Indigenous males and 63 for Indigenous females, compared to 76 for non-Indigenous males and 82 for non-Indigenous females.2

'Indigenous health experts say that poor access to culturally appropriate primary care is the main cause,' ANF Acting Federal Secretary Ged Cowin said. 'The gains in Indigenous health status in North America, Canada and New Zealand have been made because of improved access to primary care - and training Indigenous people to provide it.'

Getting more Indigenous people into the workforce is critical but progress has been slow. The latest data shows only 0.3% of doctors and 0.5% of nurses in Australia are Indigenous, well below the 2.4% Indigenous representation in the population.

Dr Sally Goold, Chair of the Congress of Aboriginal and Torres Strait Islander Nurses (CATSIN), said more support of Indigenous people through the education system was essential. Dr Goold also argues that the broader health community needs to be educated about Aboriginal history and culture and so they can care for Indigenous people appropriately.

Chairperson of the national peak body for Aboriginal community controlled health services (NACCHO) Tony McCartney, says Australia already has an excellent policy for addressing Indigenous health - the National Aboriginal Health Strategy, developed in 1989, but never implemented.

'The development of this strategy was a true consultation with community and government... but the government has failed to implement it. But it is still as relevant today as it was then,' Mr McCartney said.

Although total per capita health funding for Indigenous people exceeds that of non-Indigenous people, there is strong evidence that much of the money is not being used. Indigenous Australians actually access health services (apart from acute hospitals) at much lower rates than non-Indigenous Australians. Latest available figures on federal government spending on Indigenous health through the MBS and PBS systems amount to $224 per capita, well short of the $601 spent per non-Indigenous person.3

'We have the facts and the solutions, now we just need to fund those solutions and make them happen,' Ms Cowin said. 'There needs to be a commitment to invest in Indigenous health. We know from overseas experience that the appalling state of Indigenous peoples' health can be addressed.'

The ANJ article has examples of where primary health models have worked well. Inala health Centre, QLD; Port Lincoln Aboriginal Health Service, SA; Nganampa Health Service, SA; Redfern Aboriginal Medical Service, NSW; Derby Aboriginal Health Service, WA. The feature 'Deadly: Indigenous health today' is available in full here.

References
1. Cooke, M. On Leaving Home: Return and Circular Migration Between First Nations and Prairie Cities, Unpublished PhD thesis, University of Western Ontario
2. Australian Bureau of Statistics and Australian Institute of Health and Welfare.
3. Econtech Pty Ltd, Costings model for Aboriginal and Torres Strait Islander Health Services, Consultant report no 3, Review for the Australian Government's Aboriginal and Torres Strait Islander Primary Health Care Program.


Media inquiries:
Jill Iliffe, ANF Federal Secretary 0419 576 590
Ged Cowin, ANF Assistant Federal Secretary 0417 053 322
Heather Witham, ANF Federal Communications Officer 0417 359 907

The ANF, representing 140,000 members, is the professional and industrial voice for nurses in Australia.