Indigenous disadvantage in Australia header2

Disadvantage may have both immediate social, economic and cultural determinants, and deeper underlying causes.

 In 2008, the Australian government made a formal commitment to address First Nations disadvantage in Australia, known as “Closing the Gap”, but what's ‘the gap’?

The gap refers to the vast health and life-expectation inequality between First Nations people and non-Indigenous people in Australia. This inequality includes:

    • shorter life expectancy
    • higher rates of infant mortality
    • poorer health
    • lower levels of education and employment.

The Closing the Gap strategy has resulted in some improvements, but national statistics indicate there's still a long way to go. In 2017, the government came under pressure to add a target to lower the imprisonment rates of First Nations people. Other areas where statistics show a concerning gap in the experience between First Nations people and non-Indigenous Australians are child removals, and community and family violence.

Social and cultural determinants of health

Social and cultural determinants of heath refer to the fact that the way we live, work and play affects our health. This means racism and discrimination, lack of education or employment, and cultural disconnection impact on a person's health (Wright and Lewis 2017, p. 25).  

Disadvantage may have both immediate social, economic and cultural determinants, and deeper underlying causes.

“The relatively high rates of violence in Aboriginal and Torres Strait Island communities are influenced by immediate factors such as alcohol and illicit drug use, mental health issues and childhood experience of violence. However, a number of researchers also suggest that deeper underlying causes include ‘intergenerational trauma’ resulting from the ongoing and cumulative effects of colonisation, loss of land, language and culture, the erosion of cultural and spiritual identity, forced removal of children, and racism and discrimination.”
(SCRGSP 2014, p. 1.7)

It's important to view contemporary disadvantage among First Nations people in the context of colonisation and its ongoing impact.

Infant mortality and life expectancy

Between 2014 and 2016, First Nations children aged 0–4 were more than twice as likely to die than non-Indigenous children. In the Northern Territory, infant mortality of First Nations children was four times higher than the national rate (ABS 2017a). 

From birth, First Nations people have a lower life expectancy than non-Indigenous Australians:

  • Non-Indigenous girls born in 2010–2012 in Australia can expect to live a decade longer than First Nations girls born the same year (83.2 years and 73.7 years respectively) (AIHW 2014).
  • The gap for men is even larger, with a 69.1 year life expectancy for First Nations men and 79.9 years for non-Indigenous men (ABS 2013). 
  • First Nations women also experience approximately double the level of maternal mortality in 2016 (Wright and Lewis 2017, p. 13).  

Physical and mental health

There's a strong connection between low life expectancy for First Nations people and poor health.

  • In 2016, First Nations children experienced 1.7 times higher levels of malnutrition than non-Indigenous children (Wright and Lewis 2017, p. 13). 
  • In 2014–15, hospitalisation rates for all chronic diseases (except cancer) were higher for First Nations people than for non-Indigenous Australians (ranging from twice the rate for circulatory disease to 11 times the rate for kidney failure) (SCRGSP 2016, p. 4.75). 
  • Just under half (45%) of First Nations people aged 15 years and over said they experienced disability in 2014–2015, compared to 18.5% of the whole Australian population in 2012 (SCRGSP 2016, p. 4.69). 

Other major concerns include mental health, suicide and self-harm.

  • In 2015, the suicide rate for First Nations people was double that of the general population (ABS 2016a). The suicide rate for First Nations people in the Northern Territory increased from 5% of the suicide population in 1991, to 50% in 2010, despite First Nations people making up only 3% of the total Australian population. The age group most at risk is young people 10–24 years old, where First Nations suicide represented 80% of the suicide population in that age group, in 2010 (Gooda and Dudgeon 2014, p. 32).
  • 33% of First Nations adults reported high levels of psychological distress in 2014–15, and hospitalisations for self-harm increased by 56% between 2004–05 and 2014–15 (Wright and Lewis 2017, p. 14). 

Education and employment

  • About 62% of First Nations students finished year 12 or equivalent in 2014–15, compared to 86% of non-Indigenous Australians. This is an improvement on previous years (DPMC 2017, p. 43). 
  • The proportion of people aged 20–64 with or working towards post-school qualifications has also increased (from 26% in 2002 to 42% in 2014–15) (Wright and Lewis 2017, p. 14). 
  • The employment to population rate for First Nations people aged 15–64 was around 48% in 2014–15, compared to 75% for non-Indigenous Australians (ABS 2016b). 

Family and community wellbeing

  • Median weekly income for First Nations people was $542 in 2014–15 compared with $852 for non-Indigenous Australians (AHMAC 2017).
  • Around 20% of First Nations people lived in overcrowded households in 2014–15. In very remote areas the overcrowding was almost 40% (ABS 2016b).
  • Rates of family and community violence in 2014–15 were around 22% for First Nations people (Wright and Lewis 2017, p. 14). 
  • First Nations children were almost 10 times more likely to be placed in out-of-home care than non-Indigenous children in 2015–16 (AIHW 2017).  

Incarceration

  • In September 2017, First Nations people represented 27% of the total full-time adult prisoner population, while accounting for approximately 2% of the total Australian population aged 18 years and over. The adult imprisonment rate increased 77% between 2000 and 2015 (ABS 2017b). 
  • The detention rate for First Nations children aged 10–17 years was 26 times the rate for non-Indigenous youth in 2016 (AIHW 2016, p. 10). 
  • In 2008, almost half of First Nations males (48%) and 21% of females aged 15 years or over had been formally charged by police over their life time (AHMAC 2015). 

Moving forward together

The Closing the Gap strategy has made some improvements to First Nations people’s health since it was introduced in 2008. Sadly, all except one of the seven Close the Gap targets were behind target in 2016. 

More needs to be done in order for First Nations people to enjoy health and life-expectancy equality in Australia.


References