NACCHO Aboriginal Health #SocialDeterminants : #Indigenous education represented a “potent, practical and achievable road to change life expectancy by 12 years

 “Improvements in educational attainment could boost Indigenous life expectancy by as much as 12 years.

While clinicians focus on medical advances to benefit health care, real improvement in Indigenous health will come through attention to factors such as education, gender, power, racism and employment conditions,

These daily living factors constitute the social determinants of health, which are responsible for major health inequalities between population groups.”

 Researchers say Writing in the MJA

Read over 80 NACCHO articles over 5 years about Social Determinants

Dr Michael B Hart of the Social Determinants of Health Alliance, and co-authors, said that education represented a “potent, practical and achievable road to change” that had been overlooked as a force for health improvement.

They pointed to an analysis of evidence that contrasted a difference in life expectancy of 10–12 years between people with less than a high school education and people with an advanced degree, compared with a life expectancy difference of 6 months between people with elevated low-density lipoprotein cholesterol levels versus normal cholesterol levels.

While the MJA authors noted that a causal link between education and health had yet to be found, they said that the estimation that life expectancy could be increased by up to 12 years by improving educational attainment was “too compelling to ignore”.

Professor Steven Larkin, Pro Vice-Chancellor of Indigenous Education and Research at the University of Newcastle, said that the article presented a sophisticated analysis of the problem, but that the lack of evidence regarding causation made it difficult to draw firm conclusions.

“Consequently, we may well ask: does improving education lead to improved health outcomes? Or is it because of your improved health outcomes that you achieve better educational outcomes?” said Professor Larkin, who is also a former CEO of the National Aboriginal Community Controlled Health Organisation and a former adviser to the Australian Medical Association.

He said that it may also be that health and education were more likely to be a part of a broader range of macro socio-economic determinants that had an impact on the holistic quality of life and status of health.

The MJA article noted encouraging trends in education, with the proportion of Indigenous 20–24-olds who had achieved schooling to Grade 12 or equivalent increasing from 45.4% in 2008 to 61.5% in 2014–15.

However, they added, concerns remained, with 2013 Northern Territory data showing that less than half of Indigenous children had reached the Grade 3 minimum reading standard, compared with the national figure of about 90%.

In May of 2017, in acknowledgement of the 50th anniversary of the 1967 referendum, the federal government announced a raft of Indigenous education programs. The $138 million education package includes scholarships and mentoring programs for secondary students, a scholarship fund for students in STEM (science, technology, engineering and mathematics) degrees, as well as a program to raise the aspirations for tertiary studies.

Professor Larkin said that a key barrier to educational attainment was the lack of recognition of the depth of cultural difference.

“There is an underlying assumption of cultural homogeneity in operation here, and that’s one of the major issues for the lack of success and lower levels of Indigenous engagement and participation,” Professor Larkin told MJA InSight. “We basically have teachers who are trained in the Western educational paradigm. They are using Western curricula materials and pedagogy, and they are expecting people who are culturally different and for whom English is a second or third language to automatically be able to comprehend and study effectively under those imposed conditions.”

Professor Larkin said that seeking out more versatile, heterogenous curricula and teaching methods could help improve educational outcomes.

“We have had a pedagogy that has been designed around what constitutes best quality teaching, rather than how do people learn better. It’s a subtle but significant shift.”

He said that underperformance in measures such as NAPLAN (National Assessment Program – Literacy and Numeracy) showed a clear need for a rethink of the assumptions underpinning the delivery of education to Indigenous children.

“It’s not about dispensing with Western education, it’s just saying, can’t we do this in different ways to achieve better outcomes?”

Professor Larkin that said a lack of Indigenous leadership in both education and health was another factor that needed closer consideration.

He said that there was a need for more Indigenous Australians in the roles of employers, managers, decision makers and thought leaders.

“As much as we need non-Indigenous leadership on this, it has to be complemented by Indigenous leadership,” Professor Larkin said. “Non-Indigenous people may have the experience in the field, and they may have a developed understanding, but they are never going to be able to see the reality and understand that reality from an Indigenous point of view.”

NACCHO Aboriginal health and education : Rise of Aboriginal PhDs heralds a change in culture


“Increased funding for indigenous health research by  the National Health and Medical Research Council  has helped attract  post-graduate students in the health sector. (NHMRC funding for indigenous  health research increased from $9.4 million in 2003 to $45 million in 2013.)

”We have Aboriginal nurses as well as doctors who have undertaken PhDs,”

Professor Ian Anderson, assistant vice-chancellor for Indigenous higher  education policy at Melbourne University

Indigenous Australians are enhancing their culture through  increased academic achievements.

Andrew Bock Sydney Morning Herald:

Please note the spelling of indigenous is not NACCHO policy

Just 55 Aboriginal and Torres Strait Islander students were awarded PhDs in  Australia from1990 to 2000, but 219 students earned PhDs in the 11 years to  2011, a fourfold increase.

The number of Aboriginal and Torres Strait Islander students completing  doctoral degrees has quadrupled in the past two decades and a new generation is  preparing to influence the institutions of knowledge in Australia.

Dr Sana Mary Nakata, 30, whose father, Martin Nakata, was the first Torres  Strait Islander to complete a PhD, finished her doctorate in 2012 and is now  teaching political theory at Melbourne University. Her goals in doing a PhD were  twofold: ”To establish myself as one of this country’s first indigenous  political theorists – first as a political theorist and an indigenous political  theorist second,” Dr Nakata says.

”Indigenous people can make great contributions off the sporting field. I  would like the intellectual potential and contributions of Aboriginal and Torres  Strait Islander people recognised.”

Promising: Professor Ian Anderson says the higher intake is significant.
Promising: Professor Ian Anderson says the higher intake is significant.  Photo: Michael Clayton-Jones

Genevieve Grieves, 37, is the daughter of Dr Vicki Grieves, the first  Warraimay person to gain a PhD; in February she started a PhD at Melbourne  University to explore the representation of Aboriginal people in south-east  Australia and to help ”get projects going between universities, government  departments and museums that better present Aboriginal culture and give  Aboriginal people better access to their own culture”.

Ms Grieves says she is fortunate to have the precedent set by her mother, and  she in turn is helping others consider higher education. ”I’m normalising it  for younger people in the community around me.”

Just 55 Aboriginal and Torres Strait Islander students were awarded PhDs in  Australia from 1990 to 2000, but 219 students earned PhDs in the 11 years to  2011, a fourfold increase, according to the Department of Education. A  remarkable 143 PhDs were awarded in the five years to 2012, according to the  last available data. Moreover, 324 indigenous students were enrolled in PhDs in  Australia in 2012.

Academic legacy: Professor Martin Nakata.
Academic legacy: Professor Martin Nakata.

Professor Ian Anderson, assistant vice-chancellor for indigenous higher  education policy at Melbourne University, says the increase ”represents a  maturation of the education agenda and is significant in terms of a growing  intergenerational achievement. It will enable Aboriginal people to have input  into the knowledge economy, inspire policy and influence political  decision-making, leadership and institutional reform.”

According to the last census data, 362 indigenous Australians had PhDs in  2011, including honorary or overseas doctorates; 28 doctorates were awarded in  2012 in Australia and data for 2013 is still to be added, so it’s likely the  number of Aboriginal and Torres Strait Islander people with PhDs in Australia  has topped 400.

Although these numbers are still a long way from a benchmark parity rate of  2.2 per cent with the non-indigenous population recommended by a 2012 review of  indigenous higher education, the growth is having a multiplier effect.

Doctore Sana Mary Nakata.
Doctor Sana Mary Nakata. Photo: Jeffrey Glorfeld

In 2007, Misty Jenkins, from Ballarat and Gunditjmara descent, became the  first indigenous person to study at Oxford and then Cambridge University, after  completing a PhD in immunology at Melbourne University. Although her research on  cancer cell death at the Peter MacCallum Cancer Centre is not specifically  indigenous, she sits on several boards devoted to indigenous higher education  and research. She also helped expand indigenous postgraduate programs at  Cambridge and Oxford, where Paul Gray, in experimental psychology, and Christian  Thompson, in fine arts, are this year completing PhDs.

Aboriginal and Torres Strait Islander people did not enter tertiary education  until the 1950s. Dr Margo Weir, 74, finished a diploma in physical education in  1959 at Melbourne University and completed a PhD in curriculum design and  evaluation in 2000. ”It’s the PhDs in institutions that influence the knowledge  parameters of those disciplines,” she says. ”If you are an Aboriginal PhD, you  are importing Aboriginal culture and knowledge into that framework.”

Professor Steven Larkin, pro vice-chancellor for indigenous leadership at  Charles Darwin University, says PhD graduates can change the way those who  follow conduct research,  adding that Aboriginal PhD students need supervisors  who understand ”conflicts of knowledge culture”.

Another change wrought by having more Aboriginal and Torres Strait Islander  academics  could be enhanced debate across communities. ”At the moment there  are one or two voices that dominate, Professor Larkin says. ”We might have  those views challenged, and I think that’s a good thing. Out of difference comes  creativity and innovation.”

If Aboriginal PhD graduates are to influence indigenous politics, doctorates  may need to generate ”different analyses and contribute new knowledge”, Dr  Sana Nakata says, to which Professor Larkin adds: ”Our understanding of  disadvantage, for example, may need to change to generate new ways to tackle  it.”

Dr Grieves, a research fellow at the University of Sydney, says indigenous  knowledge is being recognised in universities around the world but she is  philosophical about its political impact in Australia. ”Our PhD system is not a  system that produces academic activists like those in other parts of the  world,” she says. ”The education system here is really about individual career  plans. I don’t hold out a lot of hope that 400 Aboriginal people with PhDs are  going to change things for Aboriginal people.

Dr Grieves believes people who have been activists should be running research  programs, ”but they’re not”.

”Those people – Gary Foley, Jim Everett and Paul Coe, for example – have  been our great thinkers and researchers,” she says. Gary Foley was awarded a  PhD for research on the history of Aboriginal organisations last year.

She also points to concerns that people with PhDs ”are not being employed in  top positions at universities in favour of Aboriginal bureaucrats”.

The growth in doctoral numbers can be attributed to several factors,  including better supervision, more scholarship programs, and the establishment  of centres such as Murrup Barak at the University of Melbourne and Nura Gili at  UNSW.

Dr Bill Jonas, a Worimi man and the first indigenous person to receive a PhD,  in 1980, cites the importance of indigenous research centres established at five  universities in the mid-1990s and, before that, programs designed to help  Aboriginal people with lower entry scores get into academic programs.

Professor Anderson says increased funding for indigenous health research by  the National Health and Medical Research Council  has helped attract  post-graduate students in the health sector. (NHMRC funding for indigenous  health research increased from $9.4 million in 2003 to $45 million in 2013.)

”We have Aboriginal nurses as well as doctors who have undertaken PhDs,” he  says.

According to census data, Aboriginal PhD students are more likely to study  society and culture, education and the arts,  and are under-represented in the  fields of health, science and engineering.

But these trends may already be changing, according to Professor Martin  Nakata, who chairs Australian Indigenous Education and is director of Nura Gili  at the University of NSW. More than 40 per cent of the 340 undergraduate  students at UNSW last year were studying law, maths or science, and more than 60  were studying medicine, he says.

These doctorates have been achieved by the ”individual effort and sheer  commitment of student and supervisor”, Professor Nakata says. ”If anything,  this achievement has been due to their effort. I know what it’s like to work in  knowledge convergences, and it’s tough.”

Dr Grieves adds: ”We come from one of the longest surviving cultures in the  world, which is, and has always been, a highly intellectual culture.”

You can hear more about Aboriginal health and Close the Gap at the NACCHO SUMMIT


The importance of our NACCHO member Aboriginal community controlled health services (ACCHS) is not fully recognised by governments.

The economic benefits of ACCHS has not been recognised at all.

We provide employment, income and a range of broader community benefits that mainstream health services and mainstream labour markets do not. ACCHS need more financial support from government, to provide not only quality health and wellbeing services to communities, but jobs, income and broader community economic benefits.

A good way of demonstrating how economically valuable ACCHS are is to showcase our success at a national summit.



NACCHO Close the Gap:Prevention not intervention,$22 million funding boost

Julia Education

The Gillard Government will be delivering a $22 million funding boost to help more than 3000 Indigenous students across the country complete their secondary education.

School Education Minister Peter Garrett today announced the Government will provide an additional $10 million to the Australian Indigenous Education Foundation this year, and a further $12 million under the Indigenous Youth Leadership Program over the next four years as part of the 2013-14 Budget.

Mr Garrett said the extra funding for the Australian Indigenous Education Foundation will help support another 733 Indigenous students to attend boarding school.

“This funding boost means that since 2008, Labor has delivered a total of $32 million to the Foundation, benefitting more than 2,300 Indigenous students across the country,” Mr Garrett said.

“As part of our agreement with the AIEF, every dollar the Commonwealth invests is matched by a dollar from corporate and private support, meaning the organisation will benefit from a total of $64 million as a result of our support.

“These scholarships are crucial in helping young Indigenous people complete Year 12 and ensuring they have an opportunity to secure a job and lead fulfilling lives.

“Education is the passport out of poverty for many young Indigenous people and this extra funding will help even more students reach their goals.

“It also has a ripple effect in communities. The more young people who finish school and get into university, the more role models there are for future generations of Indigenous youth. ”

The new funding for the Indigenous Youth Leadership Program will support 204 new scholarships for Indigenous students.

The additional funding in this year’s budget will provide scholarships for 68 students in 2014 in each of Years 7, 8 and 11.

Since 2006, more than 1,500 secondary and tertiary students have been assisted under the IYLP. More than 86 per cent of students have been retained in the program or have completed Year 12, and more than 98 per cent of students who have begun Year 12 have completed the year.

Indigenous Affairs Minister Jenny Macklin said the Gillard Government had made unprecedented investments to help close the gap on Indigenous disadvantage.

“After years of underinvestment and neglect, Labor’s investments are making a real difference for Indigenous people,” Ms Macklin said.

“This year we are meeting our first closing the gap target, with more Indigenous children having access to pre-school or kindergarten than ever before, and our target of halving the gap in mortality rates for Indigenous children under five by 2018 is also on track to be met.

“The new funding announced today will build on this good work, helping even more Indigenous kids gets every chance at a good education, a good job and a brighter future.”

Ms Macklin said the Government was delivering sustainable, long term investments to close the gap.

“Mr Abbott has so far refused to guarantee funding for Indigenous programs and organisations,” Ms Macklin said.

“This Labor Government has set out a clear pathway to close the gap on Indigenous disadvantage, and we’re making the investments that are needed to get there.

“We won’t close the gap without the certainty of these long-term investments, or without partnerships between government and Indigenous organisations.

“The progress we’ve made in partnership with Indigenous people is at risk under a conservative Abbott Government.”

This additional funding is on top of around $690 million already invested by the Gillard Government in Indigenous education, including:

  • $543 million to support the Stronger Futures NT National  Partnership;
  • more than $128 million to for the Australian Indigenous Education  Action Plan; and
  • nearly $20 million for the Teach Remote program which places high   quality teachers into remote communities.

The Gillard Governments National Plan for School Improvement will also include a particular focus on the needs of Indigenous children.

Funding for schools will be based on a Schooling Resource Standard, which includes a base amount per student and additional funding for schools and students that need more support, including indigenous students.

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