Health and wellbeing of First Nations people

For Aboriginal and Torres Strait Islander (First Nations) people, good health is more than the absence of disease or illness; it is a holistic concept that includes physical, social, emotional, cultural, and spiritual wellbeing, for both the individual and the community.

This page highlights some of the key issues in First Nations health and includes links to more detailed information.

Burden of disease

Burden of disease analysis is a way of combining the fatal and non-fatal effects of diseases in a comparable way. It measures the impact of different diseases and injuries in terms of the number of years of healthy life lost due to living with illness or premature death. More than counting deaths or disease prevalence, it also takes into account age at death and severity of disease. It produces valuable summary measures of a population’s health and also allows for the burden caused by different diseases and injuries to be ranked and compared.

The latest available data from the First Nations Burden of Disease Study 2022 (AIHW 2026b) found that, in 2022, First Nations people as a whole lost more than 317,000 years of healthy life due to ill-health and premature death – equivalent to 311 years for every 1,000 people. Living with illness or injury (non-fatal burden) and dying prematurely (fatal burden) contributed equally to this burden. After adjusting for population growth and ageing, there was a 6.3% decrease in total burden between 2011 and 2022. This was driven by an 11% drop in fatal burden over the period, while there was no substantial change in the non-fatal burden.

The leading 5 disease groups contributing to burden in First Nations people in 2022 were:

• mental health conditions & substance use disorders (such as anxiety, depression, and drug use), contributing 20% of total burden
• injuries (such as falls, road traffic injuries, and suicide), 13%
• cardiovascular diseases (such as coronary heart disease and rheumatic heart disease), 11%
• cancer and other neoplasms (such as lung cancer and breast cancer), 11%
• respiratory diseases (such as asthma and chronic obstructive pulmonary disease), contributing 7.7% of total burden.

Musculoskeletal conditions also contributed substantially to non-fatal burden, and infant & congenital conditions to fatal burden (Figure 1).

Coronary heart disease was the leading individual disease contributing to burden among First Nations people in 2022, responsible for 6.0% of total burden. The burden due to coronary heart disease has fallen substantially since 2011, driven by a decrease in fatal burden. Considerable effort has been made to improve cardiac care for First Nations people in recent years through the Better Cardiac Care measures for Aboriginal and Torres Strait Islander people.

Comparison of burden of disease results for First Nations and non-Indigenous Australians shows that, overall, First Nations people experience burden at 2.1 times the rate of non-Indigenous Australians, but that the absolute gap narrowed between 2011 and 2022 (AIHW 2026b).

The impact of chronic conditions

Chronic conditions are long-term health conditions (that is, lasting for at least 6 months) that contribute to ill-health and may lead to premature death. People with one or more chronic condition can have complex health needs, and may require assistance with daily living activities. Examples of chronic conditions include heart disease, chronic obstructive pulmonary disease (COPD), chronic kidney disease, arthritis, depression, hearing problems, and dementia. Many chronic conditions are more common among First Nations people than among non-Indigenous Australians, and occur at a younger age.

Based on the 2022–23 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) an estimated 2 in 3 First Nations people (70%) have at least one long-term health condition, with 41% reporting 3 or more (ABS 2024). ABS survey data indicate that between 2004–05 and 2022–23, the proportion of First Nations people with 3 or more long-term health conditions increased from 29% to 41%.

Commonly reported conditions included eye/sight problems (41%, an estimated 408,800 people), asthma (17%, 165,400), ear/hearing problems (13%, 131,300), back problems (14%, 138,900) and arthritis (11%, 111,200). An estimated 73,800 First Nations people (7.4%) had diabetes mellitus, 21,300 (2.1%) had COPD, and 14,200 (1.4%) had kidney disease (Figure 2).

Eye health, hearing health, and oral health

In 2023–24, the prevalence of eye/sight problems among First Nations people was 41% based on self-reported data from the ABS NATSIHS (note that this includes corrected refractive error) (ABS 2024).

Vision loss has a profound impact on a person’s quality of life and ability to perform everyday activities, for example, by limiting opportunities for physical mobility, work, education, and social engagement (Razavi et al. 2018). In the 2022-25 Australian Eye and Ear Health Survey, 11.2% of First Nations participants experienced vision impairment (11%) or blindness (0.2%) (AIHW 2026a).

Preventable vision problems, such as trachoma, diabetic retinopathy and cataracts, affect First Nations people aged 40 and over at much higher rates than non-Indigenous Australians of the same age. The Eye health measures for Aboriginal and Torres Strait Islander people annual report provides an evidence base for monitoring changes in eye health among First Nations people, identifying inequalities and highlighting potential gaps in service provision.

Hearing health and oral health problems are 2 issues that also particularly affect First Nations children, especially those living in remote areas.

Among First Nations children aged 0–14, the estimated proportion reporting an ear or hearing problem decreased from 11.2% in 2001 to 4.9% in 2022–23 (AIHW 2025). Middle ear infection was reported as a long-term ear or hearing problem affecting 2.7% of First Nations children aged 0–14 (8,800 children) in 2022–23.

First Nations children are more likely than non-Indigenous children to experience tooth decay and to be hospitalised for dental problems (AIHW 2023a). Several factors contribute to the poorer oral health of First Nations children, including social disadvantage and lack of access to appropriate diet and dental services.

Specific programs such as the Northern Territory Remote Aboriginal Investment Oral Health Program, the Northern Territory hearing health outreach program, and the Queensland Deadly Ears program aim to diagnose and treat these problems and reduce their impact on the First Nations community.

Social and emotional wellbeing

Social and emotional wellbeing is the foundation of physical and mental health for First Nations people. It is a holistic concept that encompasses the importance of connection to land, culture, spirituality and ancestry, and how these affect the wellbeing of the individual and the community (Gee et al. 2014).

Figure 3: Model of social and emotional wellbeing

Source: Kimberley Aboriginal Medical Services (2022).

First Nations people’s experience of social and emotional wellbeing varies across different cultural groups as well as across individuals. The concept of social and emotional wellbeing also recognises that a person’s wellbeing is influenced by the social determinants of health, engendered through the inequity of government policies, institutional racism, the effects of colonisation and other past events. For more information, see Determinants of health for First Nations people.

Social and emotional wellbeing is not the same as mental health and mental illness, but they can interact and influence each other (PM&C 2017). The National strategic framework for Aboriginal and Torres Strait Islander peoples’ mental health and social and emotional wellbeing 2017–2023 (the Framework) recognises this distinction and proposes a model of social and emotional wellbeing with 7 overlapping domains (Gee et al. 2014; PM&C 2017).

For many First Nations people, good mental health is indicated by feeling a sense of belonging, having strong cultural identity, maintaining positive interpersonal relationships, and feeling that life has purpose and value (Dudgeon et al. 2014; Dudgeon and Walker 2015). Conversely, poor mental health can be affected by major stressors such as removal from family, incarceration, death of a close friend or family member, discrimination, and unemployment, as well as stressors from everyday life (Gee et al. 2014; PM&C 2017).

In 2022–23, based on self-reported survey responses, an estimated 29% of First Nations people aged 2 and over had a diagnosed mental health or behavioural condition, and 3 in 10 (30%) First Nations adults experienced ‘high or very high’ levels of psychological distress (ABS 2024). 

Furthermore, disruptions to family and kinship connections, removal of children from their families (Stolen Generations) and other removals resulting in inter-generational trauma, have been linked to increased suicide and suicidal behaviour in First Nations communities (Dudgeon et al. 2021). 

The Stolen Generations

The Stolen Generations survivors and their families are a particular group of Aboriginal and Torres Strait Islander people who experience greater disadvantage than other First Nations people. Analysis of data from the 2014–15 National Aboriginal and Torres Strait Islander Social Survey showed that people who reported being removed from family were more likely than those who did not to have been imprisoned or arrested in the previous 5 years, to have low income, to have poor self-assessed health, to have poor mental health, and to have experienced homelessness in the previous 10 years. This disadvantage persisted through the generations, with adult descendants and co-resident children also experiencing poorer health and wellbeing outcomes compared with other First Nations people (AIHW 2019a, 2019b).

Suicide deaths

Reducing deaths by suicide and suicidal behaviour among First Nations people is an issue of major concern for many First Nations communities and a public health priority for all Australian governments. Suicide was the fifth leading cause of death among First Nations people in 2024 (298 deaths), accounting for 5.5% of all deaths (data for New South Wales, Victoria, Queensland, Western Australia, South Australia and the Northern Territory only), and the 17th leading cause of death for non-Indigenous Australians in these 6 jurisdictions (2,882 deaths, of 1.7% of all deaths) (ABS 2025a). Among First Nations children aged 5–17 during the 5-year period 2020–2024, suicide was the leading cause of death for females, and second leading cause for males (ABS 2025d).

Target 14 in the National Agreement on Closing the Gap is a significant and sustained reduction in suicide of Aboriginal and Torres Strait Islander people towards zero.

Between 2018 and 2024, the rate of suicide among First Nations people increased, however this trend should be interpreted with caution as the increases may be due to improvements in Indigenous identification in deaths data over time rather than underlying changes in the suicide rate (Productivity Commission 2026).

When adjusted for population size and age-structure, the suicide rate among First Nations people is more than double that of non-Indigenous Australians (ABS 2025b).

Suicide and self-harm behaviours arise from a complex set of interrelated personal, social, and historical factors (Dudgeon et al. 2017), but they can be prevented. For more information on suicide prevention among First Nations people, see the Indigenous Mental Health and Suicide Prevention Clearinghouse.

Life expectancy and deaths

Life expectancy is widely used as an indicator of population health. In general, life expectancy is higher in females than males, and lower in remote than in non-remote areas. Given current mortality patterns:

• First Nations males born in 2020–2022 could expect to live 71.9 years, and First Nations females 75.6 years
• First Nations males and females living in Major cities expected to live around 5 years longer than those living in Remote and very remote areas (ABS 2023).

Due to significant changes in Indigenous identification over time in both the Census and in death records and the mismatch between how the Indigenous status information is collected in each, it is not possible to compare life expectancy estimates for 2020–2022 with those from earlier time periods (ABS 2023). 

The median age at death for First Nations people in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory combined has increased from 57.8 years in 2014 to 63.2 in 2024 (ABS 2025c). In 2024, the leading specific causes of death among First Nations people in these 5 jurisdictions were coronary heart disease, chronic lower respiratory diseases, diabetes, cancers of the lung, bronchus and trachea, and intentional self-harm (ABS 2025a).

Deaths data can also be analysed by broad causes of death. The leading 5 broad causes of death for First Nations people in the 5-year period 2019–2023 were cancer and other neoplasms (24% of deaths), cardiovascular disease (21%), injury and poisoning (14%), respiratory disease (9.4%) and endocrine, nutritional and metabolic diseases (8.8%) (AIHW 2026c).

There have been recent improvements in how Indigenous status is derived in deaths data. While improving the quality of the data overall, these changes have introduced a break in time series in First Nations death statistics in 2022 in NSW, and 2023 in Victoria, with corresponding impacts at the national level (ABS 2025b).

Between 2016 and 2021 (the last year before the break in series), the age-standardised death rate for cancer and other neoplasms increased by 15% for First Nations people in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory combined (AIHW 2026c). There was no significant change in the age-standardised rates for deaths due to cardiovascular disease between 2016 and 2021 for First Nations people.

The Aboriginal and Torres Strait Islander Health Performance Framework provides detailed information on life expectancy and deaths among First Nations people, including infant and child mortality, leading causes of death, avoidable and preventable deaths, and changes over time.

It’s not the same everywhere

On average, First Nations people living in remote areas have higher rates of disease burden and lower life expectancy compared with those in non-remote areas. Key contributors to this include differences in educational and employment opportunities, in access to health services, in housing circumstances, and in other factors that support healthy behaviours (such as the availability and cost of fresh fruit and vegetables). But areas of relative advantage and disadvantage also exist within these regions. Local areas and communities may experience different issues and outcomes to others and have different needs and priorities. Looking at variations across smaller geographic areas can help to highlight specific areas of need, so that programs and services can be directed where they will be of most benefit.

Where do I go for more information?

For more information on the health and wellbeing of First Nations people, see:

• Aboriginal and Torres Strait Islander Health Performance Framework
• Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2018
• Indigenous Mental Health & Suicide Prevention Clearinghouse
• Department of Health, Disability and Ageing Aboriginal and Torres Strait Islander health

For more on this topic, see First Nations people.