“Close the gap is about generational change and there are no quick fixes. Real gains, although small, are already being made in life expectancy and other key areas like maternal and child health. We need to see continued, long-term commitments from all levels of government in the programs that work. In health, it’s Aboriginal Community Controlled Health Services that are making the biggest inroads against the targets to close the gap. They are also contributing to other targets, such as in employment, as the largest employers of Aboriginal people.”
National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson Matthew Cooke (pictured left with Deputy chair Sandy Davies)
NACCHO and the Campaign Steering Committee welcomes the absolute gains in Aboriginal and Torres Strait Islander life expectancy from 2005-2007 to 2010-2012. Over that five-year period, life expectancy is estimated to have increased by 1.6 years for males and by 0.6 of a year for females. But a life expectancy gap of around ten years remains for Aboriginal and Torres Strait Islander people when compared with non-Indigenous people.
Both the modesty of the gains, and the magnitude of the remaining life expectancy gap remind us why the Council of Australian Governments’ (COAG) Closing the Gap Strategy and the target to close the life expectancy gap was needed. It remains necessary today. But we must also keep in mind that closing the life expectancy gap requires time. The Closing the Gap Strategy was operationalised in July 2009 and the latest data we have is from 2012-2013. This is too short a time to adequately assess the progress of this Strategy in achieving outcomes.
Instead, the Campaign Steering Committee look to reductions in smoking rates, improvements to maternal and child health outcomes and demonstrated inroads into the impact of chronic diseases as evidence that the Closing the Gap Strategy is working.
The findings of the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS), the largest biomedical survey ever conducted among Aboriginal and Torres Strait Islander people, are critical. The survey identified high levels of Aboriginal and Torres Strait Islander people with undetected treatable and preventable chronic conditions that impact significantly on life expectancy. Armed with this data, the Campaign Steering Committee believes the nation now has an enhanced ability to make relatively large health and life expectancy gains in relatively short periods of time.
To do this, there needs to be a much greater focus on access to appropriate primary health care services to detect, treat and manage these conditions. And the evidence is that Aboriginal Community Controlled Health Services (ACCHS) provide the best returns on investment in terms of providing both access to health services and the quality of those services.
As such, this report affirms the need to keep on track with the Closing the Gap Strategy and, with patience, many indicators suggest improvements to life expectancy will be seen in time. Any reduction in effort or momentum will squander the investment we have made as a nation up until now.
The comparison between the life expectancy of Maori peoples and Aboriginal and Torres Strait Islander peoples is illustrative. In 2010-12 an increase of approximately four years has been reported for the Maori life expectancy over the previous decade. But this occurred after two decades of effort in New Zealand. This demonstrates that substantial change is possible but it takes sustained and continuous effort.
The Campaign Steering Committee emphasises the need to ensure that potential changes in Commonwealth-State relations do not have the unintended effect of undermining the Closing the Gap Strategy. While recognising that all jurisdictions have a responsibility to contribute, the Campaign Steering Committee firmly supports the Australian Government’s continuing leadership role in an overall national approach.
The Campaign Steering Committee recognises the value in the new Indigenous Affairs priorities of the Australian Government: education, employment and community safety. But there are concerns. In particular, a clearer connection between the Indigenous Advancement Strategy and the Closing the Gap Strategy will enhance both policies. Employment, education and community safety are drivers of improved health and wellbeing. However, good health is equally important to employment, education and community safety. Further, the health sector is the biggest employer of Aboriginal and Torres Strait Islander people and increased investment in health services will result in increased employment.
The Campaign Steering Committee is also concerned that hard won Aboriginal and Torres Strait Islander health gains could be negatively impacted by proposed measures contained in the 2014-15 Budget. Potential cuts to the Tackling Indigenous Smoking programme are of particular concern and could hinder the significant progress made in reducing Aboriginal and Torres Strait Islander smoking rates in recent years. Investment in early prevention activities saves on the provision of complex care into the future. These programmes also address and have started to make inroads into primary prevention, particularly in healthy eating, nutrition and physical activity.
The development of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (Health Plan) will be pivotal in our shared efforts to close the gap. It provides an opportunity to increase the quality and efficiency of services, address service gaps by building on the existing capacity of ACCHS, and to expand the Aboriginal and Torres Strait Islander health workforce.
The Campaign Steering Committee remains steadfast in its belief that the road to closing the health gap is embodied in the Close the Gap Statement of Intent signed by the Australian Government and most state and territory governments. The Close the Gap Statement of Intent commits parties to genuine partnerships with Aboriginal and Torres Strait Islander peoples, ensuring appropriate evidence based health services, strengthening the ACCHS sector, effective planning and the use of targets, and addressing the social determinants of health.
Close the Gap Day
The Close the Gap campaign is Australia’s biggest public movement for health equality. It is a coalition of Australia’s leading Indigenous and non-Indigenous health and human rights organisations.
Picture above: NACCHO CEO and our members at Parliament House in February launching the Close the Gap report
The call to end to health inequality between Aboriginal and Torres Strait Islander and other Australians continues to get louder, with a record number of events being held nationwide today Thursday 19 March to mark National Close the Gap Day.
Community groups, health services, schools, businesses, government offices and individuals around Australia are registering online to hold a Close the Gap event in their homes, workplaces, schools and communities, with last year’s record of 1298 events already exceeded.
Over 1,548 National Close the Gap Day events are scheduled for this Thursday, at schools, parks and other locations in Sydney, Melbourne, Perth, Brisbane, Adelaide, Coffs Harbour, Mount Isa, Normanton, Darwin, Mt Gambier, and Newcastle.
Close The Gap Campaign Co-Chairs Kirstie Parker and Mick Gooda are encouraged by the groundswell response from everyday Australians to National Close the Gap Day.
“Last year, more than 150,000 people took part in more than 1000 separate National Close the Gap Day events across the country,” said Ms Parker. “This year is on track to be even bigger.”
Ms Parker, who is also Co-Chair of the National Congress of Australia’s First Peoples, said National Close the Gap Day is an occasion when Australians tell the nation’s leaders that they want progress on Aboriginal and Torres Strait Islander health equality.
“The reality is that Aboriginal and Torres Strait Islander people can expect to live approximately 10 years less than non-Indigenous Australians. But there are practical steps we can take to change this,” Ms Parker said.
“We need governments to work in partnership with Aboriginal and Torres Strait Islander people because real and sustained engagement with our communities is one of the critical success factors.”
Mr Gooda, who is also Social Justice Commissioner at the Australian Human Rights Commission, said new research into the high level of undetected chronic conditions in Aboriginal and Torres Strait Islander people demonstrates the significant impact chronic conditions have on life expectancy.
“We have a real opportunity to make relatively large health and life expectancy gains in relatively short periods of time if we detect and treat these chronic conditions.
“There is no room for complacency. Funding for anti-smoking initiatives must continue and we need to fund new initiatives that target chronic conditions such as diabetes, otherwise momentum will be lost,” Commissioner Gooda said.