On April 2 the National Aboriginal Community Controlled Health Organisation and Oxfam Australia published Close the Gap, a report highlighting the shameful state of Indigenous health in Australia. The report ranked Australia as the worst at improving the health of indigenous people compared with other wealthy nations.
Aboriginal and Torres Strait Islanders die nearly 20 years younger than other Australians. This is in stark contrast to the US, Canada and New Zealand, where the life expectancy for indigenous people is approximately seven years less than the non-indigenous population. Aboriginal and Torres Strait Islander infant mortality is three times the rate of other Australians.
Nearly three times as many Australian Aboriginal and Torres Strait Islander children die before the age of five than indigenous children in Canada. Infant mortality rates for Australian Aboriginal and Torres Strait Islanders are more than 50% higher than for indigenous children in the US and New Zealand. These figures reinforce the findings of the 2003 United Nations Human Development Report, which found the proportion of Aboriginal and Torres Strait Islander Australians expected to live to the age of 65 is lower than for Third World nations like Bangladesh and Nigeria.
While spending on Aboriginal and Torres Strait Islander health has increased, it hasn't done so any faster than for the rest of the population, so the expenditure gap hasn't narrowed. The federal government spends approximately $0.70 per capita on Aboriginal and Torres Strait Islander people's health for every $1 spent on the rest of the population. Executive director of Oxfam Australia Andrew Hewett said: "At what point do we stand up and start shouting? It's scandalous that in a country as wealthy as Australia we cannot solve a health crisis affecting less than 3% of the population."
The report argues that the poor levels of health in Australia's Aboriginal and Torres Strait Islander population can be reversed. Most of the diseases leading to premature death, hospitalisation and chronic disability are preventable if diagnosed early and treated with affordable medicines. Many of the poor health outcomes for Aboriginal and Torres Strait Islanders are related to social and economic factors: diseases triggered by poverty; overcrowded housing; poor sanitation; lack of access to education; poor access to medical care for accurate diagnosis and treatment; and poor nutrition.
The report calls for government action, including:
•Improving access for Aboriginal peoples and Torres Strait Islanders to culturally appropriate primary health care, and to a level commensurate with need;
•Increasing the number of health practitioners working within Aboriginal health settings, and further development and training of the Indigenous health work force;
•Improving the responsiveness of mainstream health services and programs to Aboriginal peoples and Torres Strait Islander health needs;
•Greater targeting of maternal and child health and greater support for Indigenous-specific population programs for chronic and communicable disease;
•Increased funding and support for the building blocks of good health such as awareness and availability of nutrition, physical activity, fresh food, healthy lifestyles, and adequate housing;
•Setting national targets and benchmarks towards achieving healthy equality, by which progress can be closely monitored.
Aboriginal rights and prison reform campaigner Alex Gater told Green Left Weekly, "We have the worst health in Australia. My elders died of old age; now as an Anglican priest I'm burying too many Aboriginal people that are too young." She added, "Governments have been promising to fix Aboriginal poverty and health for too long. Oppression and racism have kept us on the bottom rung unable to access decent health, education and legal services. We want action and we want it now."
The report provides several examples of Aboriginal and Torres Strait Islander health successes like the Nganampa Health Council. Operating on the Anangu Pitjantjatjara Yankunytjatjara Lands in the far north-west of South Australia, this health service has a sustained national reputation for best practice clinical services, leading edge collaborative program research and development and for the collection of outcome data as a basis for ongoing evaluation.
It is controlled, owned and managed by the Anangu people, who are responsible for all key policy, resource allocation and staff appointment decisions. The director and clinic managers are Anangu and together they ensure that all 120 staff are accountable to the Anangu people and that Anangu determine the development and delivery of services.
Oxfam is running a campaign to lobby the state, territory and federal governments to address the shameful state of Indigenous health. The full Close the Gap report and campaign information can be viewed online at http://www.oxfam.org.au/campaigns/indigenous/health.php.