Overview
Overall, Indigenous Australians experience lower levels of access to health services than the general population, attributed to factors such as proximity, availability and cultural appropriateness of health services, transport availability, health insurance and health services affordability and proficiency in English.
On this page
Distance to, and availability of, health professionals, services and facilities
One measure of accessibility is taken by gauging where people live in relation to health services. Approximately 26% of Indigenous Australians live in remote or very remote areas of Australia compared to only 2% of non-Indigenous Australians. Aboriginal and Torres Strait Islander people are therefore more likely, as a population, to live further from health services than other Australians.
In 2002 there were 281 medical practitioners per 100,000 population employed in 'remote and very remote' areas compared with 312 per 100,000 in major cities. The most significant shortage of health professionals in 'remote and very remote' areas is of specialist clinicians where there were only 29 per 100,000 compared to 114 per 100,000 in major cities.
In 2001, 78% of discrete Indigenous communities were located more than 50km from the nearest hospital, and 50% were located more than 25km from the nearest community health centre.
Other factors affecting access
Access to medical services is also affected by factors such as the availability of transport, the affordability of private health insurance and the clients' proficiency in English. Results of the 2001 Census show that Indigenous households were generally larger than other households, and less likely to have a motor vehicle, potentially restricting their access to health services.
Results from the 2002 NATSISS show that approximately 60% of Indigenous people aged 18 years and over have access to and are able to drive a motor vehicle, compared to 85% of non-Indigenous people. This proportion was lower in remote areas, where only 48% of Indigenous people had access to a vehicle. Indigenous people were 3 times as likely to have transport difficulties in that they could not, or often had difficulties getting to places they need to go, compared to non-Indigenous people (12% compared to 4%).
Overall, results from the 2001 National Health Survey show that 17% of Indigenous Australians in non-remote areas had private health insurance, compared with 51% of other Australians, reducing the access of Aboriginal and Torres Strait Islander people to specialist care, such as private hospitals and services within the private health system.
Measurement of the accessibility of health services involves other factors besides the distance people must travel and the financial costs incurred (Ivers et al. 1997). The perception of cultural barriers may cause Indigenous Australians to travel substantial distances in order to access health services delivered in a more appropriate manner than those available locally (Ivers et al. 1997). The willingness of Indigenous Australians to access health services may be affected by such factors as community control of the service, the gender of health service staff, and the degree of proficiency in spoken and written English (Ivers et al. 1997). Aboriginal and Torres Strait Islander people who speak English as a second language and those who speak Aboriginal English, a separate dialect from Standard Australian English, often experience difficulty in approaching services such as hospitals to obtain information and treatment (House of Representatives Standing Committee on Aboriginal and Torres Strait Islander Affairs, 1993).
Indigenous health and community services workforce
The availability of Aboriginal and Torres Strait Islander staff is an important factor in whether or not Indigenous Australians are able to effectively access services (Ivers et al. 1997). In the 2001 Census, Indigenous Australians aged 15 years and over were less likely (1.5%) than other Australians (3.1%) to be employed in health-related occupations. Indigenous Australians were more likely to report being employed in selected welfare and community service-related occupations than health-related occupations. About 2.7% of those employed in community and welfare service-related occupations were Indigenous compared with 1.6% of non-Indigenous adults.
Overall in 2003, 167 Indigenous students (aged over 20 years) completed health related undergraduate courses and 105 completed welfare-related undergraduate courses, representing 1.0% and 1.5% respectively of all students completing undergraduate courses in these fields - well below the 2.4% Indigenous representation in the Australian population.
Further information
For more general information on health services available in rural and remote areas, go to Rural health.