Aboriginal health

While Canada, the United States and New Zealand have managed to lift the health standards in their Indigenous communities since the 1980s, Australian Aboriginal people suffer a worsening health crisis as these statistics show.

Selected statistics

2..3
Aboriginal infant mortality rate compared to other Australians. 80% die under the age of one.
3
Aboriginal death rate compared to the total Australian population.
1.95
Rate at which Aboriginal people are hospitalised compared to non-Indigenous people.
125
Number of Indigenous doctors practicing in Australia, compared to 60,000 non-Aboriginal doctors [13].
44%
Percentage of adult (15-plus) Aboriginal people reporting 'excellent' or 'very good' health in 2008, unchanged from 2002 [20].
76%
Percentage of Indigenous infants (aged 0-3 years) who were breast-fed in 2008 [20].
36
Times sexually transmitted Gonorrhoea is more prevalent in Indigenous communities than in other communities [17].
30
Times Aboriginal children are more likely to suffer from anaemia and malnutrition due to iron deficiencies [16].
7..12
Times 25-34 year-old Aboriginal Australians are more likely to die from heart disease than non-Aboriginal Australians [11].
25%
Percentage of Aboriginal people who reported having used an illicit substance in the last 12 months (stable rate between 2002 and 2008) [9].
1.6
Times Aboriginal people are more likely to have recently used cannabis than non-Aboriginal people [6].
0.8%
Percentage of the overall Federal health expenditure in 2009 which was spent on Aboriginal health [24].
30%
Percentage of adults in Aboriginal communities suffering from type-2 diabetes [3].
13%
Number of Indigenous homes having functioning water, waste, cooking and cleaning facilities (of 4,000 Indigenous homes surveyed during 1998-1999 in the Northern Territory).
6.5
Times an Indigenous youth aged 15 to 24 is more likely to have sexually transmitted infections [1].
12.4%
Percentage of Aboriginal people aged over 45 years with dementia. Same rate for non-Aboriginal people: 2.6% [14].
60%
Percentage Aboriginal people are more likely to die from all cancer types than non-Indigenous people [8]. Cancer is the second leading cause of death for Aboriginal people.
6
Times sexually transmitted Chlamydia is more prevalent in Indigenous communities than in other communities [17].
10
Times Aboriginal people living in remote communities are more likely to develop dementia than people living in countries such as Africa, India or Indonesia [15].
5%
Percentage of clients of disability services in 2008/9 who were Aboriginal. Same figure for the NT: 50% [7].
83%
Percentage of Aboriginal children in the NT who had some decayed, missing or filled teeth. Average waiting time between referral and receipt of service: just over 14 months [12].

List of linked articles

List of short articles

To us, health is about so much more than simply not being sick. It's about getting a balance between physical, mental, emotional, cultural and spiritual health. Health and healing are interwoven, which means that one can't be separated from the other.—Dr Tamara Mackean, Australian Indigenous Doctors' Association [13]

Australia is the only place on the planet where Indigenous health and wellbeing are going backwards.—Sydney Morning Herald [18]

Aboriginal-controlled health services can succeed

Aboriginal health is an area full of failed attempts to better the situation, but there are also a few positive stories.

The Aboriginal and Torres Strait Islander Community Health Service operating in Brisbane is the second Aboriginal community-controlled health service in Australia [4], operating since the 1970s.

The service is proud of their success [4]:

  • Patient visits to their doctors doubled from around 9,000 in 2009 to more than 18,000 in 2011.
  • In 2011 they did more than 5 times as many health checks as in 2008-09.
  • More than 2,000 new patients came to the health service in 2011.
  • Dentist visits were up 50% in the same period.
  • The service opened 2 new clinics in Logan and Caboolture.
  • The clinics created 28 new health jobs for Aboriginal people.

Factors for success

If healthy lifestyle programs are community-managed and initiated they can be effective in improving physical activity levels and nutrition among Aboriginal people [23].

Positive results include stable diabetes rates and significant falls in smoking rates, cholesterol levels and blood pressure.

“Strategies that have been found to work to strengthen Indigenous organisational capacity include long-term partnerships between government and Indigenous people,” says Dr Fadwa Al-Yaman, spokesperson of Closing the Gap Clearinghouse, a government-funded health initiative [23]. He says that partnerships should “recognise local contexts and take a developmental approach” and be clear about what exactly they are set to achieve.

Hepatitis

A comic showing an Aboriginal woman in a doctor's practice. Hepatitis cartoon. The Transmission Magazine is published by independent charity Hepatitis NSW. It targets Aboriginal people by using tailored cartoons mixed with informative pages [25].

8.3%
Number of Aboriginal Australians suffering from chronic hepatitis B and C. Same figure for non-Aboriginal people: 1.8% [5].

Aboriginal people make up 2.5% of Australia’s population yet they are 8% of the hepatitis C population [5], a figure which could be far higher considering that many people have not been tested and could have the virus.

Less than 2% of Aboriginal and Torres Strait Islander people access treatment, and if they suffer from other diseases the barrier to seek treatment is even higher. Few of them know that hepatitis B and C could be managed and hepatitis C can be cured.

Fact Hepatitis B was first diagnosed in an Aboriginal person in 1964 [5].

For more information visit Hepatitis NSW or call the Hepatitis Helpline on 02-9332 1599 (Sydney), 1800 803 990 (NSW) or 1800 648 491 (QLD).

Cardiovascular disease

Cardiovascular Disease (CVD) is among the leading causes of death for Aboriginal people.

Almost 12% of Aboriginal people have a long-term heart or related condition, and the number of deaths from CVD is more than 3 times that of non-Aboriginal Australians [21]. The disease contributes to about one third of the life-expectancy gap.

The higher prevalence is attributed to a range of risk factors such as smoking and poor nutrition, but also socio-social factors such as social isolation and depression.

Heart disease mostly affects relatively young Aboriginal people aged between 15 and 29 [28].

Dental health

Rates of dental decay in remote Aboriginal communities are often worse than 70% [10]. A 5-year study of children under 10 found that 78% of Aboriginal children had dental disease, compared with only half of other kids [27].

Such poor health is caused by a lack of fluoride in water supplies and poor diet, according to Prof Kaye Roberts-Thompson, a spokesperson for the Australian Institute of Heath and Welfare. A study suggests that socio-economic disadvantage is also playing a role [27].

“Historical factors such as forced familial separation, efforts of assimilation, on-going problems with alcohol, domestic abuse and land ownership issues… also play important roles,” the study says.

Many communities also have limited access to dental services, and children are not taught good oral hygiene.

Of children aged 12, nearly half had a history of dental decay in the permanent teeth [10]. The average number of decayed, missing and filled teeth was 1.1.

Dental problems often lead to tooth loss, difficulties with eating, problems with speech and infections that spread to other parts of the body [27]. They can also cause extreme pain that disrupts sleep, and damages concentration and self-esteem.

Mental health

Aboriginal people living in remote communities are 10 times more likely to develop dementia than people living in countries such as Africa, India and Indonesia; and 5 times more likely than non-Indigenous people [14,15]. In the Kimberley region between 13 and 27% of elderly Aboriginal people have dementia., compared to 2.6% amongst non-Aboriginal people aged 45 and over [26].

Other statistics show that remote Aboriginal people are 26 times more likely to develop dementia at a relatively young age (between 45 and 59 years) than the rest of Australians [26].

Smoking, stroke, head injury and no formal education are the main contributors to the high rate, with the good news that most of these factors can be changed.

Other risk factors are unemployment, underemployment and low status jobs, high rates of drug and alcohol use; brain trauma and increased rates of diabetes, hypertension, renovascular and metabolic disease [26].

Mental health is worst among Aboriginal prisoners where up to 93% of Aboriginal detainees have some form of mental illness.

Another factor is less obvious. The colonisation of Australia has caused much trauma among Aboriginal people. Because they couldn’t cope with what was happening many developed mental illnesses [19].

The dispossession, loss of identity, loss of land, this has all led to a whole lot of lost people.—Liz Hayden, Aboriginal Health Unit, Graylands Hospital, WA [19]

Discriminatory behaviour also contributes to bad mental health, eroding Aboriginal people’s self-esteem and value within their community [22].

Health professionals found that just treating the psychiatric illness is not enough [19], but a holistic approach is required that takes in the historical perspective. Many Aboriginal children who were stolen from their families and grew up on missions came back as “fragmented people” [19] with mental health problems.

Video: Discussing Dementia: Losing the Dreaming

Learn about people living with dementia in the Aboriginal community. The short film features Birpai Elder Uncle Bill O’Brien discussing his experience of caring for his mother, who had dementia.

Study resource

Book cover of 'Working Together' Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice outlines the historical, social, cultural, and policy contexts that have shaped Aboriginal mental health and wellbeing, highlights issues that are particularly relevant to Aboriginal people, contains a section that focuses on practice within the field, and presents examples of models and programs for practitioners.

The second edition contains a number of new chapters, providing more information on children and young people.

The Telethon Institute for Child Health Research offers free PDF copies of Working Together.

Disabled Aboriginal people

Aboriginal people with disabilities are among the most disadvantaged in Australian society and often face multiple barriers to meaningful participation in the community, Damian Griffis, Executive Officer of the First Peoples Disability Network, says [30].

50% of Aboriginal people have some form of disability or long term health condition.

“The prevalence of disability amongst Indigenous Australians is significantly higher, approximately twice that of the non-Indigenous population.

“This occurs for a range of social reasons, including poor health care, poor nutrition, exposure to violence and psychological trauma and substance abuse, as well as the breakdown of traditional community structures in some areas. Often this is the impact of removal from family and community.

“Indigenous Australians with disability are significantly over-represented on a population group basis among homeless people, in the criminal and juvenile justice systems, and in the care and protection system (both as parents and children).”

“Most Indigenous Australians with disabilities remain at the periphery of the disability service system,” Damian says. Many are reluctant to identify as people with disability due to how Aboriginal culture views disability.

“Culturally, our people treat disability and impairment as a part of life, a part of our community and just get on with it. In other words, it is not always an obvious step to seek out help and support from outside family networks.”

Singer Geoffrey Gurrumul Yunupingu is a prominent disabled Aboriginal person.

Dealers target Aboriginal communities

The use of methampethamine, or ice, in some communities has reached “epidemic proportions” and is at a “crisis point”, with children as young as 12 being exposed to the drug [31].

Dealers have been targeting Aboriginal youths who have an income through jobs. They sell them large amounts of ice, knowing the youths will rack up large debts, which their families need to pay.

“Ice is a huge problem in our community,” says Andrew Jackomos, Victoria’s Commissioner for Aboriginal Children and Youth [31].

Scabies ‘normal’ in communities

Scabies, a microscopic mite, is estimated to infest more than two-thirds of children in remote communities in their first year of life [29].

It causes an itch that can expose them to bacterial infection and ultimately to lethal rheumatic heart disease. About 18 people die of the disease each year in the Northern Territory.

Scabies and skin sores are to common that they are often considered normal [in communities],” says Prof Jonathan Carapetis, head of Menzies School of Health Research in Darwin [29].

To break the cycle of infestation would require medical treatment as well as changing housing, hygiene and behaviour. Such changes have to come from communities themselves to be effective.

Cancer

Cancer is the second leading cause of death for Australian children aged one to 14 years. Interestingly, Aboriginal children are 36% less likely to be diagnosed with cancer than non-Aboriginal children [32]. Mortality rates are about the same.

Leukaemias and tumours of the central nervous system were the most common cancers among Aboriginal children.

Can you answer?

Question: Why are Aboriginal cancer rates 8% lower than those of other Australians (19%)?

Tell me!

Answer:
Because Aboriginal people die young from other causes [2].

More resources

The HealthInfoNet website is an award-winning resource translating knowledge and academic literature for Aboriginal health workers in Australia.

The site was started in 1997. Visit www.healthinfonet.ecu.edu.au for more information.

Footnotes

View article sources (32)

[1] Koori Mail 394 p.11
[2] Koori Mail, 413, p.6
[3] 'Diabetes crisis is forum target', Koori Mail 473 p.14
[4] 'Service makes a difference', Koori Mail 510 p.23
[5] 'Hepatitis danger in the spotlight', Koori Mail 507 p.51
[6] 'Grim findings in drug survey', Koori Mail 507 p.30
[7] 'More utilising disability help', Koori Mail 493 p.53
[8] 'Study looks at cancer death rates', Koori Mail 474 p.32
[9] 'Small smoking fall but grog 'a worry'', Koori Mail 494 p.22
[10] 'Tooth decay fears raised', Koori Mail 507 p.4
[11] 'Art with heart heads to Townsville', Koori Mail 487 p.46
[12] 'NT study confirms problems', Koori Mail 497 p.51
[13] 'A column by our own doctors', Koori Mail 438 p.54
[14] 'Dementia danger', Koori Mail 412 p.49
[15] 'Dementia dangers', Koori Mail 487 p.9
[16] 'Ironing out anaemia', Koori Mail 484 p.57
[17] 'Sexual health plan is a first', Koori Mail 479 p.66
[18] 'A shamed nation turns a blind eye', SMH 16/11/2009
[19] 'Action urged on mental health', Koori Mail 511 p.42
[20] 'Gains, but the gap is still wide, study finds', Koori Mail 463 p.9
[21] 'Conference gets to heart of solutions', Koori Mail 504 p.47
[22] 'What's in a name?', Koori Mail 515 p.36
[23] 'Programs win report praise', Koori Mail 519 p.68
[24] 'Call for more accountability', Koori Mail 466 p.11
[25] 'I didn't feel a thing - Part 2', Hepatitis NSW: Transmission Magazine #9, 9/8/2011 p.23
[26] 'Dealing with dementia', Koori Mail 410 p.52
[27] 'Dental disease hits our kids', Koori Mail 395 p.41
[28] 'Bush tucker back on Aboriginal menu', The Australian 18/8/1994
[29] 'Indigenous health issues get the Twitter treatment', SMH 2/4/2011
[30] 'A Step Forward For Indigenous Disability', newmathilda.com 16/7/2013
[31] 'The ice in their veins', The Age 30/8/2013
[32] 'NACCHO health news: New research on cancer among Indigenous children', nacchocommunique.com/2013/08/06/naccho-health-news-new-research-on-cancer-among-indigenous-children/, retrieved 20/10/2013

Cite this article

An appropriate citation for this document is:

www.CreativeSpirits.info, Aboriginal culture - Health, retrieved 2 October 2014