” One area of positive change is in Aboriginal and Torres Strait Islander self-governance.

Aboriginal and Torres Strait Islander Members of the House of Representatives, Senators and other senior political leaders work to improve the health and wellbeing of their people

These developments have come after years of leadership from Aboriginal Community Controlled Health Organisations (ACCHOs).” 

Extract from Summary of Aboriginal and Torres Strait Islander health status 2017

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The new Summary of Aboriginal and Torres Strait Islander health status 2017 makes keeping up to date easier. The Summary is a plain language version of the more comprehensive Overview of Aboriginal and Torres Strait Islander health status 2017.

Our annual Summary is one of our most popular publications.

This year as part of our ongoing commitment to strengths based approaches, we have highlighted improvements to health factors that contribute to positive health outcomes.

The Summary presents the latest facts and evidence and provides the workforce with the tools to keep up to date on the health of Aboriginal and Torres Strait Islander people, and in a way that is easily understood.

The Summary highlights the areas whereAboriginal and Torres Strait Islander people’s health continues to improve, such as the decline in infant mortality rates, a decline in the death rate from avoidable causes, and a decline in the death rate from cardiovascular disease.

There have also been improvements in eye health – for example, there has been a decrease in the prevalence of active trachoma among Aboriginal and Torres Strait Islander children in some remote communities.

The percentage of people who are daily smokers continues to fall which is another positive step as tobacco smoking is a major risk factor for ill health.

Introduction

This Summary of Aboriginal and Torres Strait Islander health status 2017 is based on the Overview of Aboriginal and Torres Strait Islander health status 2017 produced by the Australian Indigenous HealthInfoNet. It provides information about:

• population
• births
• deaths
• major health problems
• health risk and protective factors.

Many reports and publications about Aboriginal and Torres Strait Islander people focus on the negative differences between Aboriginal and Torres Strait Islander people and non-Indigenous people. We pledge to also report positive differences and improvements in health whenever the information is available.

In this Summary, as part of our ongoing commitment to strengths based approaches, we have highlighted improvements to health and factors that contribute to positive health outcomes .

Most of the information in this Summary comes from government reports, particularly those produced by the Australian Bureau of Statistics (ABS) and the Australian Institute of Health and Welfare (AIHW).

Data for these reports come from:

• health surveys (for example, the Australian Aboriginal and Torres Strait Islander health surveys)
• hospitals and other government agencies (such as the birth and death registration systems and the hospital in-patient collections)
• doctors across Australia.

The accuracy of identification of Aboriginal and Torres Strait Islander people in health data collections varies across the country

In this Summary, unless otherwise stated, statistics collected in the following jurisdictions New South Wales (NSW), Queensland (Qld), Western Australia (WA), South Australia (SA) and the Northern Territory (NT) are considered to be adequate, for example, for mortality.

However, for some collections such as hospitalisation, data is considered adequate across Australia.

Due to the difference in the age structures of the Aboriginal and Torres Strait Islander population and the non-Indigenous population (see Figure 1), any comparison of rates between the populations requires the data to be age-standardised (see Glossary).

All comparisons of rates in this Summary will be age-standardised unless otherwise stated.

How do historical and political factors influence health?

Aboriginal people have lived in Australia for at least 45,000 years [1] and possibly up to 120,000 years [2]. Torres Strait Islander people first lived on the islands in the Torres Straits and now live across mainland Australia and the Straits [2].

Before colonisation by Europeans, both Aboriginal people and Torres Strait Islander people enjoyed a semi-nomadic lifestyle [2].

They lived in family and community groups and moved across their own territories according to the seasons.

The transition from living as active hunter-gatherers to a mostly inactive lifestyle with a Westernised diet has had serious effects on their health [3].

Colonisation led to the introduction of certain policies that have had a negative impact on quality of life and health.

Many of these policies have contributed to past and continuing experiences of:

• racism
• discrimination
• the forced removal of children
• loss of identity, language, culture and land [4].

What social factors affect people’s health?

The social determinants of health are the social factors that influence health [6]. They include the conditions in which people are born, grow, live, work and age.

These conditions are created by policies, political systems and social customs [6, 7]. Other social factors that contribute to the gap in health between Aboriginal and Torres Strait Islander and non-Indigenous people include education, employment, income and the physical environment where they live.

Education

According to the 2016 Australian Census [8], among 20-24 year old Aboriginal and Torres Strait Islander people:
• 47% completed year 12 (compared with only 32% in 2006)
• women were more likely than men to have completed year 12 (51% compared with 43%)
• people living in urban areas were more likely to have completed year 12 compared with those living in rural areas (50% compared with 34%)
• the highest proportions of people completing year 12 were in the ACT (66%) and Qld (55%); the lowest proportion was in the NT (25%).

An ABS report about schools [9] showed that in 2016:

• there were 207,852 school students who identified as Aboriginal and/or Torres Strait Islander, which was an increase of 3.6% from 20151
• 59.8% of Aboriginal and Torres Strait Islander students who started secondary school in year 7/8 continued through to year 12.
A national report on schooling in Australia [10] showed that in 2017:
• at least 77% of year 3 Aboriginal and Torres Strait Islander students were at or above the national minimum standard for reading, writing, spelling, grammar and punctuation, and numeracy
• at least 69% of year 5 Aboriginal and Torres Strait Islander students were at or above the national minimum standard for reading, writing, spelling, grammar and punctuation, and numeracy.

Employment

According to the 2016 Australian Census [8]:
• 47% of Aboriginal and Torres Strait Islander people between the ages of 15 and 64 years were employed
• 70% of Aboriginal and Torres Strait Islander people aged 15 to 24 years were either in full- or part-time employment, education
or training
• the top three areas of employment in which Aboriginal and Torres Strait Islander people worked were: health care and social
assistance (15%); public administration and safety (12%); and education and training (10%)
• Aboriginal and Torres Strait Islander men were most likely to be employed in construction (17%) and women were most likely to be employed in health care and social assistance (24%).

Income

According to the 2016 Census [8]:
• 20% of Aboriginal and Torres Strait Islander people reported an equivalised2 weekly income of $1,000 or more compared with 13% in 2011 [8, 11]
• 53% of Aboriginal and Torres Strait Islander people reported an equivalised weekly household income of between $150 and $799 (compared with 51% of non-Indigenous people reporting an equivalised weekly household income of between $400 and $1249) [8].