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photo with border: artwork from cover of feature reportThe main report

Indigenous Australians experience disproportionate levels of educational, employment and social disadvantage. Many Indigenous Australians also experience poorer health than other Australians, often dying at much younger ages. A healthy beginning in a nurturing environment, with protection from physical and mental abuse, and opportunities for personal development—such as education and employment—are all important for a long and happy life.

Demographics

  • The 2006 Aboriginal and Torres Strait Islander population was estimated to be about 517,000, constituting 2.5% of the total Australian population.
  • The Indigenous population has a relatively young age structure. In 2006, the median age was 21 years, compared with 37 years for the non-Indigenous population.
  • In 2008, nearly half (49%) of all Indigenous households were composed of families with dependent children, more than a third (39%) of which were one-parent families.

Determinants of health and welfare

Socioeconomic factors

  • Younger Aboriginal and Torres Strait Islander adults have completed more years of schooling than their parents. In 2008, of those aged 25–34 years, more than three‑quarters (78%) had completed Year 10 or above, compared with less than one-quarter (27%) of those aged 55 years and over.
  • The Year 12 retention rate for Indigenous students rose from 31% in 1995 to 45% in 2009.
  • Less than two-thirds (65%) of working-age Indigenous Australians were in the labour force in 2008, compared with nearly 4 out of 5 (79%) non-Indigenous Australians.
  • In 2008, Indigenous households were nearly 2.5 times as likely to be in the lowest income bracket and 4 times less likely to be in the top income bracket as non-Indigenous households.
  • Nearly half of all Indigenous children were living in jobless families in 2006—3 times the proportion of all children.

Housing

  • Between 1994 and 2008, the proportion of Indigenous households who were home owners or buyers rose from 26% to 32%.
  • Between 2002 and 2008, the proportion of Indigenous households living in dwellings with structural problems fell from 34% to 26%.
  • Poor access to public utilities and overcrowded houses remain significant problems, particularly in remote communities.

Community capacity

  • In 2006, nearly half (47%) of Indigenous families with dependent children were one‑parent families, accounting for 45% of dependent children.
  • One in 5 Indigenous adults reported being a victim of violence in the 12 months prior to the NATSISS.
  • In 2008–09, the rate of substantiated child protection notifications for Indigenous children was close to 8 times the rate for other children.
  • Indigenous Australians comprised more than one-quarter of all prisoners as at June 2010.
  • Between 2000 and 2010, the Indigenous imprisonment rate rose by 52%.

Behavioural factors

  • Between 2002 and 2008, the proportion of current daily smokers among Aboriginal and Torres Strait Islander people decreased from 49% to 45%. But the rate is still more than double that for non-Indigenous Australians.
  • Indigenous women were about twice as likely to be obese as non-Indigenous women, and Indigenous men were about 1.5 times as likely as non-Indigenous men in 2004–05.

Social and emotional wellbeing

  • In 2008, the majority of Aboriginal and Torres Strait Islander adults reported feelings of positive wellbeing, particularly in remote areas. But nearly one-third felt high/very high levels of psychological distress—more than twice the rate for non-Indigenous Australians.
  • Three-quarters (77%) of Indigenous adults reported that they or their close friends or family had experienced at least one life stressor in the previous 12 months.
  • More than one-quarter of Indigenous adults reported they had recently experienced discrimination.

Health and functioning

Community functioning

  • About 1 in 9 Indigenous adults spoke an Aboriginal or Torres Strait Islander language as their main language at home in 2008.
  • About 2 in 5 Indigenous adults spoke at least some words of an Indigenous language.
  • Almost two-thirds (62%) of Indigenous adults identified with a clan, tribal or language group, an increase from 54% in 2002.

Disability

  • In 2008, an estimated 8% of Indigenous adults had a profound or severe core activity limitation. The level of need for assistance among Indigenous Australians was more than twice as high as that among non-Indigenous Australians.
  • Physical disability was the most common disability type experienced by Indigenous Australians.

Health conditions

  • During 2007–09, Indigenous Australians were hospitalised for cardiovascular diseases at 1.7 times the rate for other Australians.
  • The age-standardised rate for Indigenous Australians with diabetes was 12%, compared with 4% for non-Indigenous Australians.
  • More than one-quarter of Indigenous Australians reported some form of respiratory disease in 2004–05. The hospitalisation rates for respiratory diseases among Indigenous children aged 0–4 years were almost twice the rate for other Australian children.
  • The incidence rate for end-stage renal disease for Indigenous Australians more than doubled between 1991 and 2008, from 31 to 76 per 100,000 population. Although Indigenous Australians were significantly less likely to have been diagnosed with cancer than non-Indigenous Australians in 2003–2007, they were 3 times as likely to have been diagnosed with cervical cancer, and 1.6 times as likely to have been diagnosed with lung cancer.
  • The rate of hospitalisation of Indigenous Australians for mental health problems was nearly twice that for other Australians.
  • Injury and poisoning combined was the main cause of hospitalisation (excluding dialysis) for Indigenous Australians. The most common injuries were those inflicted by another person and accidental falls.

Mortality and life expectancy

  • For the 2005–2007 period, life expectancy at birth was estimated to be 67 years for Indigenous males and 73 years for Indigenous females, representing gaps of 11.5 and 9.7 years, respectively, compared with all Australians.
  • Indigenous death rates have decreased since 1991. In particular, circulatory disease death rates have declined since 1997.
  • Between 2004 and 2008, two-thirds (66%) of Indigenous deaths occurred before the age of 65 years compared with 20% of non-Indigenous deaths.
  • In that same period, endocrine, metabolic and nutritional disorders contributed to Indigenous mortality at 6–7 times the non-Indigenous rates.
  • The Indigenous male death rates due to external causes were more than 3 times those for non-Indigenous males aged 25 to 44 years.
  • About 80% of the mortality gap (in terms of potential years of life lost) could be attributed to chronic diseases.

Health across the life stages

Mothers and babies

  • In 2009, the total fertility rate for Aboriginal and Torres Strait Islander women was 2.6 babies, compared with 1.9 for all women in Australia.
  • Motherhood during the teenage years was much more common among Indigenous girls (21% compared with 4% of all births in 2009).
  • Babies born to Indigenous mothers were twice as likely as babies born to other Australian mothers to be of low birthweight in 2005–2007.
  • The Indigenous infant mortality rate declined between 1991 and 2008, though it remains almost twice that of non-Indigenous infants.

Children

  • Aboriginal and Torres Strait Islander children aged 0–14 years died at more than twice the rate of non-Indigenous children. For Indigenous children aged 5–14 years, external causes were the leading cause of death between 2003 and 2007—3 times the rate for non‑Indigenous children.
  • The hospitalisation rate for assault on Indigenous children in 2007–2008 was more than 5 times the rate for non-Indigenous children. Indigenous children were hospitalised for burns and scalds at twice the rate of other children.
  • The pneumonia hospitalisation rate for Indigenous children aged 0–4 years was more than 3 times the rate for other children in 2006–2009.
  • Nearly 12% of Indigenous children who received a Child Health Check on or before 30 June 2009 had chronic suppurative otitis media—more than 3 times the rate the World Health Organization classes as a massive health problem.
  • There was a rise in trachoma prevalence in four of the five regions surveyed between 2006 and 2008, with trachoma found to be at endemic rates (more than 5%) in the majority of regions.

Young people

  • In 2008, almost one-third of young Aboriginal and Torres Strait Islander people (aged 16–24 years) had high or very high levels of psychological distress—more than twice the rate of young non-Indigenous Australians.
  • Indigenous young people were hospitalised more commonly for mental and behavioural disorders, at 1.8 times the non-Indigenous rate. The leading causes were schizophrenia, alcohol misuse and reactions to severe stress.
  • Assault was the most common cause of injury hospitalisation for Indigenous young people (1,440 per 100,000 population), almost 5 times that of non-Indigenous young people (298 per 100,000).
  • Indigenous young people died at a rate 2.5 times as high as that for non-Indigenous young people.

Older people

About 44% of older Aboriginal and Torres Strait Islander people reported their health status as fair/poor, and about 16% had profound or severe core activity limitations. A much higher proportion of Indigenous Australians with dementia were aged less than 75 years than non-Indigenous Australians in 2008–09.

Mortality rates for Indigenous Australians aged 50–74 years were more than double the non‑Indigenous rates in 2003–2007.

Health care and other support services

Health care

  • Health checks for older Aboriginal and Torres Strait Islander people in the September quarter of 2009 were twice the rate recorded in the March quarter of 2006.
  • Compared with non-Indigenous GP consultations between 2005 and 2010, Indigenous Australians had higher management rates for diabetes, infections, asthma and drug use, but lower management rates for preventative measures such as vaccinations and cardiac check-ups.
  • Indigenous Australians used emergency health care services more often than non‑Indigenous Australians, accounting for more than 3.8% of presentations in 2009–10.
  • Admissions of Indigenous Australians in public hospitals were nearly 4 times the rate of other Australians.
  • Indigenous Australians accounted for 6.5% of community mental health service contacts in 2008–09—close to 3 times the rate for non-Indigenous Australians.

Support services

More than one-third of Indigenous users of specialist disability services had intellectual disability as their primary reason for activity limitations. Aboriginal and Torres Strait Islander people with disability accessed support services at rates equivalent to those of non‑Indigenous Australians in 2008–09.

In 2008, Indigenous Australians with severe or profound core activity limitations encountered transport problems almost twice as often as those without disability, and had difficulty accessing health and community services.

Of all aged care residents on 30 June 2009, only 0.6% of permanent residents and 0.9% of respite residents were identified as being of Aboriginal or Torres Strait Islander origin.

Indigenous Australians aged under 65 years made proportionately higher use of residential aged care services than other Australians. At 30 June 2009, Indigenous Australians aged 60–64 years used residential aged care services at a rate of 6.7 per 1,000 population compared with 2.6 per 1,000 for other Australians.

At 30 June 2008, more than half (56%) of all Indigenous households were receiving housing assistance through various housing and rental programs.

Indigenous Australians accessed specialist homelessness services at relatively high rates, making up almost 1 in 5 of all users of services in 2008–09. Almost three-quarters of Indigenous clients were female.

Almost half of accompanying children aged 0–4 years presented to specialist homelessness services in 2008–09 were Indigenous.

In 2008–09, Indigenous couples, both with and without children, most often sought help due to accommodation problems including overcrowding.

Health and welfare expenditure

  • Indigenous health care expenditure accounted for 3.3% of national expenditure in 2006‑07, or $1.31 for every $1.00 spent for services used by a non-Indigenous person.
  • Health services for Indigenous Australians were predominantly government-funded.
  • Indigenous Australians accounted for 8.5% of all government community support and welfare expenditure in 2008–09, or $3.60 for every $1.00 spent per non-Indigenous Australian.