Back to accessibility links

Aboriginal Health and Welfare

For Aboriginal and Torres Strait Islander peoples, health is a holistic concept which incorporates the physical, spiritual, social, cultural and ecological components, rather than simply being illness free, both for the individual and the community.1

The disparity in healthcare for Aboriginal and Torres Strait Islander peoples has many contributing factors, from colonisation through to assimilation and separation policies, the impacts of which are still evident today. These impacts directly correlate to the social determinants of health, including education, housing and employment.

Aboriginal peoples also experience a higher prevalence of chronic conditions and associated risk factors, compared with non-Aboriginal people, and at younger ages. Yet, despite experiencing a higher disparity in health outcomes compared to non-Aboriginal people, access to health services remains a significant barrier.2

An understanding of the social determinants of Aboriginal health must take into account issues of dispossession and the resulting intergenerational trauma exemplified by the stolen generations, fewer opportunities for education, employment, housing, along with racism.

39%

of the gap between Aboriginal and non-Aboriginal Australians’ health outcomes can be attributed to social determinants.

This rises to 53.2% when combined with behavioural risk factors, such as tobacco use, alcohol use, dietary factors and physical inactivity.
Australian Institute of Health and Welfare 3

53.2%

Early disadvantage can have lasting effects. The first years of a child’s life provide lifelong foundations for health and wellbeing. Children who have fewer opportunities in early life are more likely to develop problems with health, development, learning and behaviours, and these problems can have a cumulative effect. For Aboriginal communities, poor health equity is reflected in higher infant and child mortality rates and, while rates have declined in recent years, Aboriginal children are 2.1 times as likely as non-Aboriginal children to die before the age of five.4

Consideration of the cultural determinants of health is just as important for Aboriginal and Torres Strait Islander peoples, as a strong connection to culture is strongly correlated with good health, through strengthened identity, resilience and wellbeing. The Aboriginal Health Impact Statement is used by NSW Health organisations to 'incorporate the health needs and interests of Aboriginal people in the development of new and revised health policies, programs and strategies'.5

    Learn more about NSW Health’s commitment to improving Aboriginal people’s health outcomes.

    For the past decade the national Closing the Gap strategy has sought to reduce Aboriginal disadvantage in health, education and employment. The strategy has a number of targets, including improving life expectancy, child mortality rates, early childhood enrolments, school attendance and employment outcomes. Central to these targets is the recognition that good health is closely associated with the socio-economic, environmental and behavioural determinants of health.6

    There have been some successes including significant reductions in the overall mortality rate and the proportion of current smokers, and improvements in Year 12 completion rates, overcrowding, homelessness and home ownership.6 However the gap in health status between Aboriginal and non-Aboriginal Australians is still marked and much more work needs to be done.8

    In February 2018 a gathering of prominent Indigenous Australians met in Canberra to discuss priorities for the next decade of Closing the Gap. Over two days participants from all states and territories shared their experiences to help influence the next steps. The Closing the Gap refresh, as it is known, is recognition that Australian governments will need to work more effectively in genuine partnership with Aboriginal and Torres Strait Islander peoples to make real improvements in health outcomes.9

    The importance of culture and tackling the social determinants of health to improve the health and wellbeing of Aboriginal and Torres Strait Islander peoples, was captured in the report My Life My Lead: Opportunities for strengthening approaches to the social determinants and cultural determinants of Indigenous health.10

    My Life My Lead report identified seven priority areas raised by participants and written submissions. These will provide important focus for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (Implementation Plan), as well as inform the Closing the Gap refresh agenda.

    These are:

    • Culture at the centre of change
    • Success and wellbeing for health through employment
    • Foundations for a healthy life
    • Environmental health
    • Healthy living and strong communities
    • Health service access
    • Health and opportunity through education

    1 Deadly Step

    1 Deadly Step

    The 1 Deadly Step program promotes screening, early detection and follow up of chronic disease in Aboriginal communities in NSW. The unique component of 1 Deadly Step is the emphasis is getting together and having fun via community sporting event to engage Aboriginal people who would not normally be screened for chronic disease.

    Agency for Clinical Innovation

    ACI Consumer Enablement Guide

    ACI Consumer Enablement Guide

    Engaging consumers to understand their health conditions and have the confidence, knowledge and ability to actively manage their health and wellbeing and access the healthcare services they need.

    ACI

    Deadly Choices

    Deadly Choices

    In Aboriginal slang, if something is ‘deadly’ it is great. Deadly Choices is empowering Aboriginal and Torres Strait Islander peoples to make healthy choices for themselves and their families – stopping smoking, eating good food and exercising daily. Deadly Choices also encourages people to visit their local Community Controlled Health Service to complete an annual ‘Health Check’ to focus on preventative health -  encouraging community to visit the doctor not just when they are unwell but to take steps to prevent and better manage chronic conditions and stay healthy.

    Healthy Homes and Neighbourhoods

    Healthy Homes and Neighbourhoods

    A population-based model that focuses on care coordination for vulnerable families with long-term complex health and social needs.

    Sydney Local Health District

    Housing for Health

    Housing for Health

    Housing for Health is a copyright methodology for improving living conditions in Aboriginal communities. The methodology focuses on improving health outcomes through environmental changes particularly for children in early life 0-5 years. Evidence indicates that improving essential health hardware (fixing a leaking toilet, electrical repairs, having sufficient hot water, having somewhere to wash a baby or child, etc.) can improve health status and reduce the risk of disease and injury.

    NSW Health

    Improving Aboriginal food security and dietary intake

    Improving Aboriginal food security and dietary intake

    Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women’s Council, Nganampa Health Council, Mai Wiru Regional Stores Aboriginal Corporation and the Australian Prevention Partnership Centre worked together in a concerted intervention to improve availability, affordability, accessibility and promotion of healthier, more nutritious food in what is usually the single store in remote Aboriginal communities in South Australia. The results of the research project show the first improvement in over 40 years in the amount of healthy and food and drinks sold.

    Australian Prevention Partnership Centre

    Make Healthy Normal

    Make Healthy Normal

    Australians are living in an environment where being unhealthy has become normal. But small lifestyle changes can make a big difference. NSW Health offers free initiatives including digital tools, information and free programs to tackle overweight and obesity to help make healthy normal.

    NSW Health

    NSW Knockout Health Challenge

    NSW Knockout Health Challenge

    The NSW Aboriginal Knockout Health Challenge is a community-led weight loss and healthy lifestyle program for Aboriginal communities across NSW. The program consists of two challenges of 10 weeks which run throughout the year.

    NSW Office of Preventive Health

    The Shed in Mt Druitt

    The Shed in Mt Druitt

    The Shed provides support to men considered to be at risk of serious stress and suicide, generally due to their disadvantaged situations often brought on by unemployment, separation or loss. Most of these men are of Aboriginal and Torres Strait Islander origin since these are often the men most at risk.

    University of Western Sydney, Holy Family Church at Mount Druitt

    1. Australian Institute of Health and Welfare. Australia’s Health 2018 Australia’s health series no. 16. AUS 221. Canberra: AIHW; 2018. p306. https://www.aihw.gov.au/reports-data/health-welfare-overview/australias-health/overview
    2. The National Aboriginal Community Controlled Health Organisation (NACCHO) Key Facts Indigenous Health 2018. https://www.naccho.org.au/  
    3. Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander Health Performance Framework. Canberra: AIHW; 2017.  https://www.aihw.gov.au/reports/indigenous-health-welfare/health-performance-framework/contents/summary
    4. Australian Institute of Health and Welfare. Australia’s Health 2018 Australia’s health series no. 16. AUS 221. Canberra: AIHW; 2018. p306.
    5. NSW Health, Aboriginal Health Impact Statement, https://www1.health.nsw.gov.au/pds/Pages/doc.aspx?dn=PD2017_034
    6. Commonwealth of Australia, Dept. of Prime Minister and Cabinet. Closing the Gap. Canberra: PM&C; 2018. https://www.pmc.gov.au/indigenous-affairs/closing-gap
    7. Commonwealth of Australia, Dept. of Prime Minister and Cabinet. Closing the Gap Prime Minister’s Report 2018. Canberra: PM&C; 2018. p11. https://www.pmc.gov.au/sites/default/files/reports/closing-the-gap-2018/sites/default/files/ctg-report-20183872.pdf
    8. Australian Human Rights Commission. Close The Gap - 10 Year Review (2018). Sydney: AHRC; 2018. https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/publications/close-gap-10-year-review
    9. https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/publications/close-gap-10-year-review
    10. Commonwealth of Australia, Dept. of Prime Minister and Cabinet. Closing the Gap refresh.
    11. Commonwealth of Australia, Department of Health. My Life My Lead - Opportunities for strengthening approaches to the social determinants and cultural determinants of Indigenous health: Report on the national consultations December 2017. Canberra: Dept of Health; 2017. p8 http://www.health.gov.au/internet/main/publishing.nsf/Content/indigenous-ipag-consultation