It is important, however, to remember that health outcomes are very much affected by factors outside the health system. For more information, see Determinants of health for First Nations people and Health and wellbeing of First Nations people.
Health system performance over time
The performance of the health system for First Nations people, as described by the measures drawn from the Aboriginal and Torres Strait Islander HPF, shows mixed results over the most recent decade. Among measures based on regularly reported data, some measures show improvement, but not all.
Improvements in health system performance for First Nations people include:
Barriers to accessing health services
Barriers to accessing health services for First Nations people include services not being available in their area (especially for those living in remote areas), services being too far away, lack of transport, cost, waiting times, and the availability of culturally safe and responsive health services. The nuances surrounding these barriers are addressed in the measure Access to services compared with need (3.14) of the Aboriginal and Torres Strait Islander HPF.
A culturally safe and responsive health system
Improving the cultural safety and cultural responsiveness of the health system can improve access to, and the quality of, health care for First Nations people. A culturally safe health system is one that respects the cultural values, strengths and differences of First Nations people, and addresses racism and inequity. It also requires health professionals and health services to be culturally responsive, to take action to overcome racism and power imbalances and to have active engagement with First Nations clients/patients to ensure that the system meets their needs (PM&C 2020; Dudgeon et al. 2010; IAHA 2019).
To measure progress in achieving cultural safety in the Australian health system, the AIHW has developed the Cultural safety in health care for Indigenous Australians: monitoring framework (AIHW 2023). For the purposes of this framework, cultural safety is defined with reference to the experiences of First Nations health care users, the care they are given, and their ability to access services and to raise concerns.
Where do I go for more information?
For detailed information on the performance of the health system for First Nations people, see the AIHW’s and the National Indigenous Australians Agency’s (NIAA’s) Aboriginal and Torres Strait Islander Health Performance Framework and linked reports.
For more information on First Nations people’s use of health services, see also:
For broader information on this population group, visit First Nations people.
