NACCHO Aboriginal Health Resources Alert : Download @HealthInfoNet Overview of Aboriginal and Torres Strait Islander health status 2019 : Continuing to show important positive developments for our mob

In the Overview we strive to provide an accurate and informative summary of the current health and well-being of Aboriginal and Torres Strait Islander people.

In doing so, we want to acknowledge the importance of adopting a strengths-based approach, and to recognise the increasingly important area of data sovereignty.

To this end, we have reduced our reliance on comparative data in favour of exploring the broad context of the lived experience of Aboriginal and Torres Strait islander people and how this may impact their health journey “

HealthInfoNet Director, Professor Neil Drew

The Overview of Aboriginal and Torres Strait Islander health status (Overview) aims to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islander people.

Download HERE 


The annual Overview contains updated information across many health conditions.

It shows there has been a range of positive signs including a decrease in death rates, infant mortality rates and a decline in death rates from avoidable causes as well as a reduction in the proportion of Aboriginal and Torres Strait Islander people who smoke.

It has also been found that fewer mothers are smoking and drinking alcohol during pregnancy meaning that babies have a better start to life.

The initial sections of the Overview provide information about:

  • the context of Aboriginal and Torres Strait Islander health
  • social determinants including education, employment and income
  • the Aboriginal and Torres Strait Islander population
  • measures of population health status including births, mortality and hospitalisation.

The remaining sections are about selected health conditions and risk and protective factors that contribute to the overall health of Aboriginal and Torres Strait Islander people.

These sections include an introduction and evidence of the extent of the condition or risk/protective factor. Information is provided for state and territories and for demographics such as sex and age when it is available and appropriate.

The Overview is a resource relevant for the health workforce, students and others requiring access to up-to-date information about the health of Aboriginal and Torres Strait Islander people.

This year, the focus will be mainly on the Aboriginal and Torres Strait Islander data and presentation is within the framework of the strength based approach and data sovereignty (where information is available).

As a data driven organisation, the HealthInfoNet has a publicly declared commitment to working with Aboriginal and Torres Strait Islander leaders to advance our understanding of data sovereignty and governance consistent with the principles and aspirations of the Maiam nayri Wingara Data Sovereignty Collective (

As we have done in previous years, we continue our strong commitment to developing strengths based approaches to assessing and reporting the health of Aboriginal and Torres Strait Islander people and communities.

It is difficult to make comparisons between Aboriginal and Torres Strait Islander people and non- Indigenous Australian populations without consideration of the cultural and social contexts within which people live their lives.

As in past versions, we still provide information on the cultural context and social determinants for the Aboriginal and Torres Strait Islander population.

However, for the selected health topics and risk/protective factors we have removed many of the comparisons between the two populations and focused on the analysis of the Aboriginal and Torres Strait Islander data only.

In an attempt to respond to the challenge issued by Professor Craig Ritchie at the 2019 AIATSIS conference to say more about the ‘how’ and the ‘why’ not just the ‘what’ where comparisons are made and if there is evidence available, we have provided a brief explanation for the differences observed.

Accompanying the Overview is a set of PowerPoint slides designed to help lecturers and others provide up-to-date information.

  • In 2019, the estimated Australian Aboriginal and Torres Strait Islander population was 847,190.
  • In 2019, NSW had the highest number of Aboriginal and Torres Strait Islander people (the estimated population was 281,107 people, 33% of the total Aboriginal and Torres Strait Islander population).
  • In 2019, NT had the highest proportion of Aboriginal and Torres Strait Islander people in its population, with 32% of the NT population identifying as Aboriginal and/or Torres Strait Islander.
  • In 2016, around 37% of Aboriginal and Torres Strait Islander people lived in major cities.
  • The Aboriginal and Torres Strait Islander population is much younger than the non-Indigenous population.

Download the PowerPoint HERE


NACCHO Aboriginal and Torres Strait Islander #RuralHealth : @RuralDoctorsAus President and CEO says quality rural and remote health care essential to #ClosingtheGap

“Both Federal and State governments, right across the country, need to step up and invest in rural health if they are serious about this.

There have been numerous examples of initiatives developed to improve access to health care in rural and remote areas being extended into urban areas to prop up under-funded services in for the socially disadvantaged.

This has resulted in the unintended consequence of further disadvantaging Aboriginal and Torres Strait Islander people living in rural and remote Australia.

We need continued investment in health infrastructure and services aimed at addressing the disparity in health outcomes between those who live in the city and those who live in the bush… and this extends across both our Indigenous and non-Indigenous populations.

Without this, as a nation we are never going to close the gap, and the divide for the health outcomes of Aboriginal and Torres Strait Island people living in rural and remote Australia will never be addressed.”

Dr John Hall, President of the Rural Doctors Association of Australia (RDAA), said that without access to high quality health services in rural areas, the gap will never close.

Photo above : Here is what GPs said about working in Indigenous health

” I’m particularly concerned with successive government failure to halve Indigenous child mortality rates.

A lot of this is about access, it’s around health literacy.

It’s also about the holistic care, it’s also around education, housing and a whole range of other things”.

Australia needs to boost hospital and birthing facilities in rural and regional areas in order to overcome entrenched Indigenous health disadvantage, according to Rural Doctors Association of Australia CEO Peta Rutherford told SkyNews .

Watch SkyNews interview HERE 

Read over 70 Aboriginal Rural and Remote Health NACCHO Articles HERE

Another disappointing Closing the Gap Report, released this month [12 February 2020], demonstrates why health care in rural and remote Australia is a key driver to Closing the Gap in health.

“The Government’s Closing the Gap Report 2020 showed that the Gap between Indigenous and non-Indigenous Australians on key health indicators has not closed,” Dr Hall said.

“Two key health-related benchmarks were chosen by the

Government in 2008, with a target of halving the gap in child mortality by 2018, and to close the gap in life expectancy by 2031.

“Neither of these targets are on track.

“The main cause of Aboriginal and Torres Strait Islander child deaths are perinatal conditions such as complications of pregnancy and birth.

“With 85 per cent of these deaths occurring during the first year of life, maternal health and risk

factors during pregnancy play a crucial role.

“Access to quality, culturally safe, medical care is the most direct way of improving these outcomes,” Dr Hall said.

Similarly, life expectancy in Aboriginal and Torres Strait Islander people is strongly influenced by health and health care, with the report attributing 34 per cent of the gap to social determinants (such as education, employment status, housing and income), 19 per cent to behavioural risk factors (such as smoking, obesity, alcohol use and diet), leaving 47 per cent attributed to what is clearly a disparity in health outcomes and associated health care issues.

In rural and remote areas there is a noticeable difference of a more than six year reduction in life expectancy of Aboriginal and Torres Strait Islander males and females, when compared to those living in major cities.

This demonstrates a failure across the board in these key areas, all of which are influenced by the provision of quality health care.

“Clearly we can’t close the gap without a functional health system in rural and remote Australia,” Dr Hall said.

“And this cannot just be solved through funding Aboriginal Medical Services (AMS); the other parts of the health system need to be equally funded to service these communities in order to be able to provide the standard of care that will result in a reduction in the gap in health outcomes.

“We can’t have hospital services downgraded and expect to close the gap.

“We can’t have communities with no access to medical birthing services and expect to close the gap.

“We can’t have people needing to travel hundreds of kilometres to access cancer or surgical treatment and close the gap.

“We need quality rural hospitals, staffed by Rural Generalist doctors, with the skills needed to meet the needs of these communities in both the General Practice and hospital settings, if we are serious about improving health outcomes and actually closing the gap.

NACCHO Aboriginal Health and #Diabetes: This health professional survey is designed to assist Dr Michael Mosley and Ray Kelly with a 3 part SBS series Australia’s Health Revolution.

” Australia’s Health Revolution is a new three-part documentary series for SBS TV that’ll be hosted by popular UK presenter and journalist Dr Michael Mosley and Australian Indigenous diabetes educator and exercise physiologist, Ray Kelly.

The series will feature people all over Australia, from all backgrounds aged between 18 and 70 who have been diagnosed with diabetes or pre-diabetes and selected to be  part of a 12 week program, following a very low energy diet designed to achieve fast weight loss and help stabilise blood sugar levels.

The documentary will explore the big picture of type 2 diabetes in Australia, and the exciting new science behind diet and lifestyle programs that are reversing type 2 diabetes – previously considered incurable.”

Hear interview with Ray Kelly

We can turn blood sugar levels within seven days. It is really a matter of days and weeks to really transform someone form going toward the massive complications that come with type 2 diabetes and heart disease and turning them to becoming much healthier,”

Ray Kelly has been running a health program across Australia around the same principles as Dr Michal Mosley in the UK with great success covering some of the toughest areas and working closely with our ACCHO’s /Aboriginal Medical Services (AMS).

Read over 160 Aboriginal Health and Diabetes articles published by NACCHO over past 8 years 

How can you be involved ? Complete this diabetes survey.

 ” This GENERAL POPULATION and HEALTH PROFESSIONAL SURVEY designed to help inform some of the themes in the series.

The survey has been devised with help from The Charles Perkins Centre (Sydney Uni). The aim of the survey is to get an understanding of the experience of certain health conditions, including type 2 diabetes, from the perspective of (i) Australians and (ii) specifically, health professional’s (those involved in diabetes care and prevention as well as those who aren’t ).

Complete the survey HERE 

What we’ve known for many years is that type 2 diabetes is both preventable and reversible.

While the solution followed in the series is pretty simple-short term calorie restriction and using fresh, wholefoods as ‘medicine’- presenters want to highlight that low calorie diet programs aren’t routinely offered by most GPs or funded by Medicare.

Ray Kelly says that the TV series cannot come soon enough as Type 2 Diabetes is the fastest growing condition in the Western world yet it is both preventable and reversible.

“What we’ve known for many years is that type 2 diabetes is both preventable and reversible.”

Across 3 episodes, Ray Kelly and Dr Mosley will also shed a light on confronting health disparities and complexities of diabetes risk and prevalence in Australia.

At times they’ll explore confronting issues asking why diabetes death and hospitalisation rates are twice as high in remote areas than in major cities and why Australians are losing a staggering 4400 limbs to diabetes-related amputations every year.

Ray Kelly encouraged families and individual from all backgrounds, especially of Indigenous ancestry, to participate in the program.



NACCHO Aboriginal Health and #Racism #Aliens : Professor Marcia Langton ” Hysteria over High Court’s ruling is hateful and wrong ” Plus extra comment Stan Grant

” Sixty-five thousand years. This is the earliest established date of human occupation on the Australian continent. It was reported two years ago by archaeologists, based on “the results of new excavations conducted at Madjedbebe”, a rock shelter in Arnhem Land. 

Last week the High Court judges implicitly acknowledged in their findings in the Love and Thoms cases that Aboriginal Australians — even those born overseas and not citizens of Australia — are not within the reach of the “aliens” power in section 51(xix) of the Constitution.

The commonwealth should not resort to entrenchment of race hate and discrimination in dealing with the intersection of criminality, mixed-descent Aboriginal people who are not Australian citizens, and the Migration Act.

This case demonstrates that rule of law is alive and well. What is not clear is whether the ideological use of race in our politics will cease.

We can be sure, though, that hysteria about these issues will continue because weaponising race in the tabloid media is commercially lucrative and builds brand value in the absence of sound citizen values and respect for the rule of law.” 

Marcia Langton is Professor of Australian Indigenous studies at the University of Melbourne. Read full article Part 2 below .

Originally published The Australian 15 February

Read over 120 Aboriginal Health and Racism articles published by NACCHO over past 8 years 

Part 1 Stan Grant 

” This was about our nation’s history: the legacy of dispossession.

Where do First Nations people fit within the Commonwealth? What is it to be Australian? Indigenous? Can we be equally one and the same?

Can two centuries of imported British law and tradition here, extinguish a connection, law, and lore that has existed for time immemorial?

These questions go to the very heart of the legitimacy of the nation. This is what Indigenous people call Australia’s unfinished business.

The judges’ opinions make fascinating and inspiring reading. They are profound, wise, and sensitive.”

The High Court has widened the horizon on what it is to be Indigenous and belong to Australia

Additional comments from Stan Grant (added by NACCHO FYI ) Read in full HERE

Part 2

Daniel Love and Brendan Thoms, ( pictured above ) the former born in Papua New Guinea and the latter in New Zealand, are not citizens but both have an Aboriginal parent. Both ran foul of the law and were charged and sentenced for assault occasioning bodily harm.

The ­Migration Act enabled Home Affairs personnel to cancel their visas, place them in immigration detention and arrange for deportation to their countries of birth. The commonwealth argued in the appeal against their deportation that “since the plaintiffs were not citizens, they were necessarily aliens, and therefore the commonwealth had the jurisdiction to ­deport the plaintiffs pursuant to s 51(xix) of the Constitution”.

The High Court found to the contrary “that the common law must be taken to have recognised that Aboriginal persons ‘belong’ to the land. This recognition is inconsistent with the treatment of Aboriginal persons as strangers or foreigners to Australia. The status of alien provided for in s 51(xix) therefore cannot be applied to them.”

Following the Mabo (No 2) decision in 1992, the response from the Coalition, business, mining, farming and grazing leaders, along with the usual pack of shock jocks, was hysterical and, above all, wrong. So, too, the response during this past week from the hard right and the far right to the High Court decisions in Love v Commonwealth and Thoms v Commonwealth: hysterical, wrong and misleading.

The facts are more important than ever. The idea of “race” — in defining Aboriginal people, in tackling our standing in the Constitution, in legislation and in our everyday enjoyment of civil rights — must be replaced by a more accurate conception of peoples with unique and ancient cultural and genealogical links to this continent.

The eastern part of Australia became a colony of England in 1770, when Lieutenant James Cook declared it a British possession at Possession Island in the Torres Strait. It was Eddie Koiki Mabo from a nearby island, Mer or Murray Island, in 1982, who challenged the arrogance of this imperialist declaration and the legal fiction on which it was based — terra nullius, the Latin term for “empty land belonging to no one” and more particularly governed by no one. In 1992, the High Court recognised within severe limits the pre-existing native title laws of the indigenous peoples and overturned terra nullius.

On January 26, 1788, the colony of NSW was established and thereafter other parts of Australia were declared colonies, eventually numbering six in all. Aboriginal societies and their territories were overrun by settlers and, in many parts, if they survived at all, they did so in much-reduced and horrible circumstances.

The impact of this history on the surviving indigenous populations are many, and the continued attacks on our self-identification as Aboriginal is one of them and, it must be said, is a new and intensified focus of racist attacks.

The contributions of Andrew Bolt to misinformed public perceptions of who is and who is not Aboriginal weaponised this style of attack among the far right. Mark Latham proposed DNA testing for all Aboriginal people, even though this is not possible given the state of the science.

Moreover, the great fear among Aboriginal people who directly bear the burden of our terrible history is the recent proposal to Home Affairs Minister Peter Dutton for a register.

This would be the worst instance of racial profiling and establish the grounds for a race-based purge of Aboriginal people. How else should they interpret the relentless drive of Dutton, whose response following the announcement of the decision in Love and Thoms was that he would amend the Migration Act?

How can he do this without suspending the Racial Discrimination Act?

Without entrenching ­racism in our laws?

The High Court affirmed the three-part definition of an Aboriginal person: he or she must be ­descended from an Aboriginal person, must identify as Aboriginal and be recognised by his or her community as such. Facts matter in assessing these issues and, despite the hysteria, that this arrangement has worked well as an administrative guideline for almost a half-century should give Australians confidence.

Australians should feel pride in our common law because it is logical and just: “It follows that a person whom an Aboriginal society has determined to be one of its members cannot answer the description of an alien according to the ordinary understanding of that word.”

Justice Virginia Bell, one of the four judges in the majority, noted: “Whether a person is an Aboriginal Australian is a question of fact.” She went on to point to the origins of the three-part definition of Aboriginality in the Tasmanian dam case in which Justice William Deane proposed the meaning of the term “Australian Aboriginal” as “a person of Aboriginal descent, albeit mixed, who identifies himself as such and who is recognised by the Aboriginal community as an Aboriginal”. Deane inclined to the view that the reference was to the “Australian Aboriginal people generally rather than to any particular racial sub-group”.

The Love and Thoms submissions relied on Justice Gerard Brennan’s formulation in Mabo (No 2) for the meaning of “Aboriginal” Australian: “(m)embership of the indigenous people depends on biological descent from the indigenous people and on mutual recognition of a particular person’s membership by that person and by the elders or other persons enjoying traditional authority among those people.”

The shift from a cultural interpretation of an indigenous polity in the Tasmanian case to a biological one in the Mabo case is a reflection of the increasing misunderstanding of the notion of race, the colonial racialisation of hundreds of Aboriginal peoples as a single race and the worsening commitment to a eugenicist view of humanity, even among our most educated.

A cultural and historical view of indigenous peoples, their antiquity and their belonging is key to getting constitutional issues right. Race is a dangerous concept and my view is that we must dispense with it.

The High Court declined, however, to determine the facts on Aboriginality in the case of Love and Thoms, and instead found: “If the commonwealth did not accept Mr Love’s pleaded case, that he is a member of the Aboriginal race of Australia, the appropriate course was for the proceeding to have been remitted to the Federal Court of Australia for the facts to be found.”

There is so much to understand about the High Court’s findings, and further issues will be raised by the Federal Court if the commonwealth does, indeed, seek clarification of the Aboriginality of Love. The commonwealth should not resort to entrenchment of race hate and discrimination in dealing with the intersection of criminality, mixed-descent Aboriginal people who are not Australian citizens, and the Migration Act.

This case demonstrates that rule of law is alive and well. What is not clear is whether the ideological use of race in our politics will cease. We can be sure, though, that hysteria about these issues will continue because weaponising race in the tabloid media is commercially lucrative and builds brand value in the absence of sound citizen values and respect for the rule of law.


NACCHO Aboriginal Health News : Read / Download Press Release responses to the 2020 #ClosingtheGap Report from #CoalitionofPeaks @closethegapOZ @NATSILS_ @SNAICC @SenatorSiewert @CAACongress @RACGP

“ These Closing the Gap reports tell the same story of failure every year

The danger of this seemingly endless cycle of failure is that it breeds complacency and cynicism, while excusing those in power.

People begin to believe that meaningful progress is impossible and there is nothing governments can do to improve the lives of our people.

The truth is that the existing Closing the Gap framework was doomed to fail when it was designed without the input of Aboriginal and Torres Strait Islander people. We know what will work best for our communities and the Prime Minister even acknowledges in this report that our voice was the missing ingredient from original framework.

The Coalition of Peaks has signed a formal partnership agreement with every Australian government, where decision-making on design, implementation and evaluation of a new Closing the Gap framework will be shared. Through this partnership, the Coalition of Peaks has put forward structural priority reforms to the way governments work with and deliver services to Aboriginal and Torres Strait Islander people.

Governments say they are listening to Aboriginal and Torres Strait Islander people. However, the true test in listening is translating the priority reforms into real, tangible and funded actions that make a difference to Aboriginal and Torres Strait Islander people right across our country.

This historic partnership could be the circuit-breaker that is needed. However, if they view this process as little more than window dressing for the status quo, the cycle of failure evident in today’s report is doomed to continue.”

Pat Turner, CEO of NACCHO and Co-Chair of the Joint Council on Closing the Gap, said that governments need to learn from these failures, not continue to repeat them.

Read Download the full Coalition of Peaks Press Release HERE

Read previous NACCHO Communiques this week

1.Coalition of Peaks Editorial Pat Turner

2.PM Launches CTG Report ( Download )

3.PM CTG Full Speech

4.Opposition response to CTG Report

“Every year for the last 12 years we have listened to a disappointing litany of failure – it’s not good enough, Indigenous Australians deserve better.

We are heartened by the developments last year with COAG and the Prime Minister agreeing to a formal partnership with the Coalition of Peaks on the Closing the Gap strategy.

Indigenous involvement and participation is vital – when our peoples are included in the design and delivery of services that impact their lives, the outcomes are far better.

However, now that partnership is in place, Australian governments must commit to urgent funding of Indigenous healthcare and systemic reform.

Preventable diseases continue to take young lives while unrelenting deaths in custody and suicide rates twice that of other Australians continue to shame us all.

As governments reshape the Closing the Gap strategy, we cannot afford for the mistakes of the past to be repeated.

Close the Gap Campaign co-Chairs, Aboriginal and Torres Strait Islander Social Justice Commissioner June Oscar AO and National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA) CEO Karl Briscoe, have called on the government to invest urgently in health equity for Aboriginal and Torres Strait Islander peoples

Download full Close the Gap campaign press release HERE

Close the Gap Campaign response to CTG Report

” There was one glaring omission from the Prime Minister’s Closing the Gap speech this week. Housing did not rate a mention. Not a word about action on Aboriginal housing or homelessness.

Housing was not even one of the targets, let alone one we were meeting, but it must be if we are to have any chance of finally closing the gap between Indigenous and non-Indigenous Australians on all the other targets for life expectancy, child mortality, education and jobs.

Aboriginal and Torres Strait Islander people make up 3 per cent of Australia’s population but 20 per cent of the nation’s homeless. Aboriginal people are 2.3 times more likely to experience rental stress and seven times more likely to live in over-crowded conditions than other Australians.”

James Christian is chief executive of the NSW Aboriginal Land Council.

“For the first time ever, there is a commitment from all Australian governments, through COAG, to work with Aboriginal leaders through the peak bodies of Aboriginal organisations to negotiate key strategies and headline indicators that will make a difference.

So long as the negotiations continue in good faith and we stay the course together this should lead to a greater rate of improvement in coming years. Of this I am sure.

There is a commitment to supporting Aboriginal people by giving priority to our own community controlled organisations to deliver the services and programs that will make a difference in our communities while at the same time ensuring mainstream services better meet our needs”

Donna Ah Chee, Chief Executive Officer of the Central Australian Aboriginal Congress : Read full Report Part 1 below.

“Today is another day we reflect on the Federal Government’s inability to meet the Closing the Gap targets.

This report clearly shows that the gap will continue to widen if reforms aren’t translated into tangible, fully funded actions that deliver real benefits to Aboriginal and Torres Strait Islander people throughout the country.

The report reveals that progress against the majority of Closing the Gap targets is still not on track. The gap in mortality rates between Aboriginal and Torres Strait Islander people and non-Indigenous

Australians increased last year and there are very worrying signs on infant mortality.

The Federal Government needs to commit to funding solutions to end over-imprisonment of Aboriginal and Torres Strait Islander people and they must be implemented alongside other areas of disadvantage in the Closing the Gap strategy – health, education, family violence, employment, housing – in order to create real change for future generations.”

Cheryl Axleby, Co-Chair of NATSILS.

“We are deeply concerned about the Federal Government’s decision to not continue funding for remote Indigenous housing. Access to safe and affordable housing is essential to Closing the Gap,”

Nerita Waight, Co-Chair of NATSILS.

Download the full NATSILS press release HERE

NATSILS response CTG Report

” SARRAH welcomes the bipartisan approach by Parliamentarians who committed to work genuinely and collaboratively with Aboriginal and Torres Strait Islander leaders.

The potential contribution of Aboriginal and Torres Strait Islander Australians is far greater than has been acknowledged or supported to date.

There are many organisations working hard to close the gap, such as Aboriginal community controlled health organisations right across Australia, and Indigenous Allied Health Australia, the national Aboriginal and Torres Strait Islander peak allied health body.

Governments, through COAG, working with the Aboriginal and Torres Strait Islander Coalition of Peaks have the opportunity to reset the trajectory.”

Download SARRAH Press Release

Media Release SARRAH Closing the Gap

“ Many of our communities are affected by a range of adverse experiences from poverty, through to violence, drug and alcohol issues and homelessness.

Without an opportunity to heal from the resultant trauma, its impact can deeply affect children’s brain development causing life-long challenges to the way they function in the world.

It is experienced within our families and communities and from one generation to the next.

We need urgent action to support better outcomes and opportunities for our children.

SNAICC CEO, Richard Weston

Download the full SNAICC press release HERE

SNAICC Response to CTG Report

“Mr Morrison will keep failing First Nations peoples and this country until a genuine commitment to self-determination is at the heart of closing the gap.

The Prime Minister’s same old “welfare” rhetoric indicates that the Government really hasn’t got it.   While they say they are committed to the COAG co-design process the PM ignores the point that it is his Government continuing to drive discriminatory programs such as the Cashless Debit Card, the CDP program, ParentsNext and who are failing to address the important social determinants of health and wellbeing.

There are a few things this Government needs to do before they just “get people into jobs”, like invest in the social determinants of health and wellbeing and a housing first approach.”

Australian Greens spokesperson on First Nations peoples issues Senator Rachel Siewert

Download the full Greens press release HERE

The Greens Response to CTG Report

” Australia’s efforts to close the gap are seemingly stuck in a holding pattern.

Though Prime Minister Scott Morrison has hailed the beginning of a ‘new era’ of improving the health and life expectancy of Aboriginal and Torres Strait Islander people in the launch of the 12th Closing the Gap report, the results are all but unchanged.”

Read RACGP editorial

Part 1 : Donna Ah Chee, Chief Executive Officer of the Central Australian Aboriginal Congress


“It’s also important to recognise that there has been progress here in Central Australia both over the longer term and more recently. Since 1973, the number of Aboriginal babies dying in their first year of life has reduced from 250 to 10 per 1000 babies born, and life expectancy has improved on average around 13 years.

As recently as 2019 we have seen significant improvements across multiple areas.

“Alice Springs has experienced a remarkable 40% reduction in alcohol related assaults and a 33% reduction in domestic violence assaults. This is 739 fewer assaults year on year, or 14 fewer assaults per week”.

“There has been a 33% reduction in alcohol related emergency department presentation which is 1617 fewer presentations year on year or a reduction of 31 per week. Corresponding with this, there has been a decline in hospital admissions and, as noted in the MJA recently, ICU admissions. These are dramatic improvements,” she said.

“The proportion of babies born of low birth weight has halved and the rates of childhood anaemia and anaemia in pregnancy have declined markedly.”

“In addition to this the number of young people who reoffend and therefore recycle through youth detention has dropped dramatically.”

“Combining all of these factors, we are closing the gap on early childhood disadvantage and trauma and this will make a big difference in coming years in other health and social outcomes.”

There are however, still many issues to be addressed, especially with the current generation of young people, as too many have already experienced the impacts of domestic violence, trauma and alcohol and other drugs. Unfortunately, this has led to the youth issues experienced now in Alice Springs.

The NT government recently advised Congress that they are implementing strategies that are aimed at making an immediate difference while at the same time we know key strategies that will make a longer-term difference are already in place. New immediate strategies include:

  1. 14 additional police undertaking foot patrols and bike patrols in the CBD
  2. Police now taking young people home where it is safe to do so, rather than telling them to go home themselves
  3. The employment of two senior Aboriginal community police officers from remote communities and the recruitment of three others in town and two at Yuendumu
  4. The flexible deployment of the YOREOs to meet peaks in the numbers of young people out at different hours of the night
  5. The much more active deployment of the truancy officers to ensure all young people are going to school.
  6. Access to emergency accommodation options for young people at night

While progress overall is slower than it should be, it is important to acknowledge the successes we are having because of the good work of many dedicated community organisations and government agencies working together in a supportive environment, where governments are adopting evidence based policies.

NACCHO Aboriginal Health and the #ClosingtheGap debate : Professor Ian Ring  “  For actual progress to occur  I suggest 7 steps fundamental shifts in policy and practice  to turn around the efforts to #closethegap “

The good news is that the lack of progress in Closing the Gaps can be turned around, but this requires capitalising on the opportunities presented by the COAG partnership and a fundamental shift in the way programs are run.

I am encouraged that First Peoples and government are finally in the one forum where funding and policy can be aligned and jurisdictional and Indigenous responsibilities assigned and monitored – through the Partnership Agreement with the Coalition of Peak Aboriginal and Torres Strait Island Organisations and the Council of Australian Governments(COAG).

This is a historic development, but one which enables but does not necessarily, of itself, guarantee progress.

For actual progress to occur, there needs to be some fundamental shifts in policy and practice.

I suggest the following 7 steps to turn around the efforts to close of the gap “

Professor Ian Ring AO, Hon DSc see full CV part 2 below : Original published ANTAR 

Read over 600 Aboriginal and Close the Gap articles published by NACCHO over past 8 years

Read all the Coalition of Peaks Closing the Gap articles published by NACCHO 

Noting the Prime Minister Scott Morrison will deliver his governments Closing the Gap report Wednesday 12 February

Close the Gap, Coalition of Peaks and Closing the Gap what is the difference ?

Close the Gap is a public awareness campaign focused on closing the health gap. It’s run by numerous NGOs, Indigenous health bodies and human rights organisations.

The campaign was formally launched in 2007, after the release of the social justice report by the Aboriginal and Torres Strait Islander social justice commissioner, Dr Tom Calma.

Close the Gap gained support from state and federal governments when the Council of Australian Governments (Coag) set two health aims among their six targets in 2008: achieving health equality within a generation and halving the gap in mortality rates for children under five within a decade.

In 2008 then prime minister Kevin Rudd and then opposition leader Brendan Nelson also signed the Close the Gap statement of intent.

The Coalition of Peaks is a representative body comprised of around fifty Aboriginal and Torres Strait Islander community controlled peak organisations that have come together to be partners with Australian governments on closing the gap, a policy aimed at improving the lives of Aboriginal and Torres Strait Islander people.

In 2016, Australian governments wanted to refresh the closing the gap policy which had been in place for ten years.  During this refresh process, many Aboriginal and Torres Strait Islander organisations told governments that we needed to have a formal say on the design, implementation and evaluation of programs, services and policies that affect us.

In March 2019, the Coalition of Peaks entered an historic formal Partnership Agreement on Closing the Gap with the Council of Australian Governments (COAG) which sets out shared decision making on Closing the Gap.

View the Coalition of Peaks Website HERE 

Closing the Gap

Closing the Gap is the name given to Coag’s 2008 national strategy to tackle Indigenous inequality, which includes the Indigenous Reform Agreement, a commitment to closing the gap between Indigenous and non-Indigenous Australians within a specific timeframe, with six key targets

View the latest Closing the Gap Website HERE

” Everyone deserves the right to a healthy future and the opportunities this affords.

However, many of Australia’s First Peoples are denied the same access to healthcare that non-Indigenous Australians take for granted.

Despite a decade of Government promises the gap in health and life expectancy between Aboriginal and Torres Strait Islander peoples and other Australians is widening.

The Close the Gap Coalition — a grouping of Indigenous and non-Indigenous health and community organisations — together with nearly 200,000 Australians are calling on governments to take real, measurable action to achieve Indigenous health equality by 2030.” 

National Close the Gap Day March 17 Campaign website

Ian Ring suggests the following 7 steps to turn around the efforts to close of the gap 

1.Target Setting

Firstly, target setting is not simply a process of setting out what results would be desirable but needs to take into account what actual services and resources would be required to achieve the targets – and how long it would take to both measure and achieve them. Targeting and budgeting must go hand in hand, and targeting without budgeting is simply a recipe for failure and disappointment.

2.Needs-Based Funding

Secondly, it is a cardinal principle behind government social policy that service provision should be related to need. For example, no one questions the fact that far more is spent on health care for the elderly than on the young who enjoy much better health.

However, while in broad terms the level of need for health care in Aboriginal and Torres Strait Islander people, based on the Burden of Disease studies is approximately 2.3 times higher than for the rest of the population, though the jurisdictions spend $2 approximately pc (87% of needs based requirements) on health for every $1 spent on the rest of the population, the Commonwealth only spends $1.21pc on Aboriginal and Torres Strait Islander people for every $1 spent on the rest of the population (barely half [53%] of the needs based requirements).

This is particularly important as the Commonwealth is largely responsible for the out-of-hospital services required to bring down preventable admissions and deaths. It is utopian and unrealistic to believe that gaps can be closed by spending relatively less on people with worse health.

This is not a plea for some kind of special deal for First Peoples but rather for a level of expenditure that anyone else of the population with equivalent need would receive.

Funds are required to address market failure, particularly with the underuse of Commonwealth funding schemes (MBS/PBS) and to fill current service gaps with services that work and particularly, services designed by and for Aboriginal people (ACCHS). Similar principles apply to other areas of government policy and service provision eg housing, education, welfare etc.

3.Focus on Services

Thirdly, there seems to be a widespread belief that targets are somehow self-fulfilling, that all that is required is to set targets, measure them and that somehow or other the targets can be achieved.

This is of course nonsense, but indicative of the need for skills training in health planning and related fields (see below). Having set targets, it is absolutely necessary to consider what services are required to achieve the targets, what services are available and what services are missing, and the investment required to fill the service gaps. For services that are available, it is fundamentally important to have evaluation as a mandatory routine to see if the services are accessible, and effective – and if not, why not, and then take the necessary management decisions to improve service delivery (see management below).


There is clear evidence across a range of fields (health, education, housing, justice etc) that significant progress is possible using methods that are tried and tested.

But Aboriginal health and related issues are not so simple that anyone can tackle them effectively. They are complex and require considerable skills and service delivery experience for effectiveness.

Throwing staff in at the deep end is inefficient, and not fair either to the staff or to Indigenous people. Health planning, for example, is a defined skill and requires specific training and a manifest lack of planning skills lies at the heart of suboptimal service delivery A fundamental understanding of culture is an absolute necessity as is a very solid grounding in service delivery experience. The need for training extends right across the board and applies to clinicians, health service administrators  and public servants.

For each individual the question needs to be asked – what training does this person require in order to fulfil their role with maximum effectiveness? It is time for amateur hour to come to an end and for the development and implementation of a National Training Plan to ensure all involved are adequately equipped  for their individual roles – and it will not be possible to adequately realise on the investments involved in Indigenous service provision without appropriate staff training.


For many, the concept of management is little better than sitting around and hoping that somehow, miraculously, next year’s results will be better. That is not how Gaps are Closed.

A formal, integrated, multilayered management system is required – supported by appropriate information and evaluation systems.

At the service delivery level there needs to be formal review processes, at least mid-year and annually, to consider both process and outcome measures in relation to the specified targets – with a timeframe that is based on trajectories which set out what results can and should be expected at different points of time.These measures need to be replicated at regional and jurisdictional levels in the context of a wider consideration of staffing, training and resourcing issues. At the national level the focus needs to be on both resourcing and policy issues. At every level, the question needs to be how well are we doing, and what needs to be done to achieve better results – and then to take the appropriate management decisions required to achieve the targets.

6.Continuous Quality Improvement

There is incontrovertible evidence that sizeable and rapid gains are possible in both chronic disease  and in the health of mothers and babies. But those gains require high quality services and are not achieved without proper systems for measuring, monitoring and improving the quality of services.

Such approaches are standard throughout industry and need to be a formal component of health service delivery and other areas of social policy. CQI processes have been used for some services but need to be mandated and funded as a national requirement so that everyone involved in Indigenous service provision lives and breathes service quality enhancement and participates in the formal processes involved.

7.Learning from national and international experience

There are many fine examples of Indigenous Health service delivery – and some of the best health services in the country are provided by the Aboriginal Community Controlled Health Services.

The Institute of Urban Indigenous Health in South-East QLD (IUIH) is an outstanding example of how to integrate Primary Health Care services, both Indigenous and mainstream, under Aboriginal and Torres Strait Islander leadership. in achieving the desired results in term of Closing the Gap.

It is just one of a number of examples around the country, but such examples need to become systematic, comprehensive and national throughout Australia. There are similar examples of services for mothers and babies which reduce low birth weight rates and lower perinatal mortality. In the important field of chronic disease, it has been demonstrated that systematic application of current knowledge can achieve dramatic reductions in mortality in short time periods.  We know what to do, have shown that impressive results can be achieved but nationally, progress in both child health and chronic disease falls a long way short of what is required. There needs to be formal support programs, to replicate successful models of these services, adapted as needed to meet local needs, right throughout Australia.

Similarly, successful programs like Housing for Health, developed for the Commonwealth (and subsequently dropped [!] but picked up by the NSW government) have improved housing and consequently health, and doing so by training and employing local Aboriginal people. It beggars belief that programs of such obvious worth are not universally delivered across Australia, and that needs to be rectified as a matter of urgency.

In other fields, child development and justice reinvestment programs have been shown to be effective and cost effective, both in Australia and overseas, but implemented on a piecemeal and patchy basis in Australia. That cannot continue.

Government budgets tend to focus on outlays rather than investment – and more importantly, return on investment. This is inefficient and, in the end, wasteful. The recent NZ Wellbeing budget shows a different approach and needs careful consideration.


None of the measures above are radical or untested or impossible to implement. Indeed, they are standard throughout much of the world. Not implementing them has proved costly in terms of poor results and suboptimal returns on investment.

The time for amateurism is over and Australia needs to lift its game. and these standard measures, under First Peoples leadership, and in the context of the COAG partnership, we can make a significant contribution to the achievement of Australia’s national Goals to Close the Gap.

The Gaps can and should be closed – but not by fine words and good intentions.

Much progress is possible in relatively short periods of time and Australia could and should be the world leader in Indigenous affairs.

Part 2 Professor Ian Ring AO, Hon DSc

Professor Ian Ring AO, Hon DSc is a Professorial Visiting Fellow, School of Public Health and Community Medicine, University of New South Wales, Adjunct Professor in the School of Indigenous Australian Studies, James Cook University and Honorary Professorial Fellow in the Research and Innovation Division at Wollongong University.

He was previously Head of the School of Public Health and Tropical Medicine at James Cook University, Principal Medical Epidemiologist and Executive Director, Health Information Branch, at Queensland Health, and Foundation Director of the Australian Primary Health Care Research Institute at the Australian National University.

He has been a Member of the Board of the Australian Institute of Health, Member of the Council of the Public Health Association and the Australian Epidemiological Association.

He is an Expert Advisor to the Close the Gap Steering Committee and a member of the International Indigenous Health Measurement Group, Aboriginal and Torres Strait Islander Demographic Statistics Expert Advisory Group, Scientific Reference Group Indigenous Clearinghouse, Australian Indigenous HealthInfoNet Advisory Board, and AMA Taskforce on Indigenous Health.

NACCHO Aboriginal Health and #ClosingtheGap : Should the government lower retirement age thresholds for Indigenous Australians, as lower life expectancy means our mob not getting fair access to the pension and super ?

” The Indigenous population is more likely not to reach preservation age, so question whether the system is fit for purpose for this cohort.

This has a significant effect on the relevance of preservation age for these members who are overwhelmingly more likely to take their accrued super under permanent incapacity and other early release provisions than at retirement age.”

Indigenous Australians were much more likely to receive a disability support pension than the age pension but in the total population this was not the case, the Australian Institute of Superannuation Trustees said, suggesting Indigenous people were more likely to become disabled before retirement.

Read all NACCHO Aboriginal Health and Elder Articles HERE 

Read AIHW Report on disability support for Indigenous Australians 

What is First Nations Foundation?

We are a national Indigenous financial foundation, led by an Indigenous board, striving to achieve economic freedom for First Nations.

​We operate on a national basis and offer programs in financial literacy, research and superannuation outreach to Aboriginal and Torres Strait Islander people. WEBSITE

Media Coverage

Superannuation funds are agitating for lower retirement age thresholds for Indigenous Australians, warning lower life expectancy means they’re not getting fair access to the pension and super.

Major fund AustralianSuper, consulting firm PricewaterhouseCoopers, the Australian Institute of Superannuation Trustees and the Australian Council of Trade Unions all raised concerns about Indigenous access to funds in retirement as part of submissions to a government review.

Australian Bureau of Statistics data shows for the Aboriginal and Torres Strait Islander population born between 2015 and 2017 the life expectancy for men was 71.6 years and for women was 75.6 years. Non-Indigenous men and women have a life expectancy of 80.2 years and 83.4 years respectively.

Gap between Indigenous and non-Indigenous life expectancy (Close the Gap Report, 2019) ANTAR

In the past decade there has been a small narrowing in this life expectancy gap. The federal government has committed $4.1 billion for Indigenous health initiatives for four years from 2019-20.

AustralianSuper’s submission to the retirement income review this week specifically pointed to this gap as a concern for the superannuation system.

The preservation age, which is when someone can access their super, is currently between 55 and 60 depending on date of birth.

The pension age is 66 for those born from 1954 to June 1955, rising to 67 years for those born after 1957.

Treasurer Josh Frydenberg last year ruled out raising the pension age to 70 as part of the first retirement income review since the 1990s. But reducing the superannuation age for specific groups of people is unlikely to be a popular proposal.

The Department of Prime Minister and Cabinet in a 2018 submission to the Banking Royal Commission said current legislation allows the early release of superannuation funds to pay for medical treatment and did not support changing the age requirements as it would run counter to the “universal aspect” of the superannuation system.

The AIST, which is part of the cross-industry Indigenous Superannuation Working Group, said that the retirement system was too often based on assessments about “full-time, male, continuously-employed, higher income earners”.

The ACTU, which has pushed for a raft of changes including increasing the super guarantee for women, wants immediate reform to lower the age pension eligibility and preservation age for Aboriginal and Torres Strait

The submission also recommends superannuation funds and relevant government services are offered in Indigenous languages and a reduction in the paperwork needed to prove ancestry.

Consulting firm PwC also flagged “unique challenges in retirement” for Aboriginal and Torres Strait islanders.

A spokesman for Minister for Indigenous Australians Ken Wyatt said that while the life expectancy gap needed to be considered there were “systemic and structural transformations required to achieve better life outcomes for Aboriginal and Torres Strait Islander people in older age”.

He said a government strategy to close the gap was focused on economic development to help intergenerational change for longer term wellbeing.

NACCHO Aboriginal Health and #FASD #BacktoSchool : Download or View @NOFASDAustralia Teachers play a critical role in facilitating positive learning and life outcomes for students with FASD.

” NACCHO in 2018 partnered with the Menzies School of Health Research and the Telethon Kids Institute (TKI) to develop and implement health promotion resources and interventions to prevent and reduce the impacts of Fetal Alcohol Spectrum Disorders (FASD) on Aboriginal and Torres Strait Islander families and young children.”

 Although high rates of alcohol consumption have been reported across all Australian populations, research shows that Aboriginal and Torres Strait Islander women are more likely to consume alcohol at harmful levels during pregnancy, thereby greatly increasing the risk of stillbirths, infant mortality and infants born with an intellectual disability.”

FASD is an umbrella term used to describe the range of effects that can occur in individuals whose mother consumed alcohol during pregnancy.

These effects may include physical, mental, behavioral, developmental, and or learning disabilities with possible lifelong implications.”

From the FASD Strategy 2018 -2028 NACCHO Post 

Teachers play a critical role in facilitating positive learning and life outcomes for students with FASD.

These children do not respond to traditional instructions or classroom management techniques, and while many children with FASD have average or high intelligence, they also have complex needs which impact many aspects of the school environment. Behaviours and challenges of a child with FASD vary, and can include:

  • learning difficulties
  • impulsiveness
  • difficulty connecting actions to consequences (don’t learn from mistakes)
  • difficulty making and keeping friends
  • attention / hyperactivity
  • memory challenges (short and long term)
  • developmental delays

NOFASD Australia’s website provides a range of resources for teachers and educators.

We have also produced a number of webinars including a 45 minute webinar for teachers which can be viewed here.

Some valuable resources include:

The Marulu FASD Strategy publication Fetal Alcohol Spectrum Disorder (FASD) and complex trauma: A resource for educators is valuable for educators and other professionals.

This book contains detailed information about FASD and how it interacts with trauma, and provides many practical strategies for supporting young people with FASD in the classroom.

South Australia’s Department of Education has a comprehensive webpage on Fetal Alcohol Spectrum Disorder which can be accessed here. This page covers the education implications of FASD, managing FASD in education and care, supporting children and families with FASD and related resources. Downloadable resources include:

  • An interoception support planwhich provides a detailed explanation and opportunity for the development of individualised strategies to assist children to understand their bodies and thus self-regulate.
  • sensory overview support planwhich can provide a detailed understanding of individual sensory difficulties and assist in developing strategies to minimise sensory overload in the education setting.
  • regulation scale which assists children and adolescents to identify what is impacting their mood, what signals their body is giving them, and ways to respond and manage their change in mood.

WRAP Schools has produced short videos based on 8 Magic Keys: Developing Successful Interventions for Students with FAS by Deb Evensen and Jan Lutke. These are valuable resources for teachers and may be beneficial for parents and caregivers too. Read an overview of each Magic Key and watch them here.

NOFASD Australia’s resource, an Introduction to Teachers, can be downloaded and completed by parents/carers to provide specific information on strengths, challenges, and effective strategies for their individual child.

We recommend you access NOFASD’s comprehensive resources for teachers and educators. Recommended links include:

Supporting students with FASD – online learning

Trying Differently Rather Than Harder – highly recommended reading

Teaching a student with FASD

Understanding FASD: A comprehensive guide for pre-k to 8 educators

What teachers can do

Finally, this video describes a shift in approach when working with students with FASD:

To read other NOFASD Australia blogs click here.

You may also like to read Edmonton and Area Fetal Alcohol Network’s blog KNOWFASD: Academic Difficulties.

NACCHO Aboriginal Health and #WorldCancerDay @CancerAustralia and @HealthInfoNet Many cancers are preventable among Aboriginal and Torres Strait Islander people

” In Australia, the poorest among us are 30% more likely to die of cancer than the richest.

There is also a big gap in cancer outcomes for our Indigenous Australian population, where incident rates from cancer are 10% higher than non-Indigenous Australians and mortality rates are 30% higher.

Similarly, cancer incidence (particularly cancers with poorer prognoses) and mortality are significantly higher outside capital cities, with outcomes worsening in step with remoteness.

So why are money, cultural background, geographic location and cancer types leading to some Australians being left behind?

More research is required to definitively pinpoint why these trends are occurring, but several factors stand out. More needs to be done to promote healthy lifestyles and cancer prevention to some parts of our community.

As an example, we know that smoking rates are higher in Indigenous populations and among poorer Australians and also link to cancers with poorer prognosis such as lung cancer.

Continued investment in anti-smoking campaigns tailored to these communities is critical in reducing this disparity. Currently around 40% of Indigenous Australians smoke compared with 12.2% of the general Australian population. In remote communities, this rises to around 60%.

Other unhealthy lifestyles that can increase cancer risk, including excessive alcohol consumption, physical inactivity, an unhealthy diet and obesity, are also more prevalent among socio-economically disadvantaged populations

Professor Sanchia Aranda is the CEO of Cancer Council Australia

Read over 75 Aboriginal Health and Cancer articles published by NACCHO last 8 years

According to the Cancer Council Australia 1 in 3 cancers could be preventable through lifestyle choices.

We know that preventing cancer is one of the most effective ways of creating a cancer free future.

At least one in three cancer cases could be prevented and the number of cancer deaths could be reduced significantly by choosing a cancer smart lifestyle.

Each year, more than 13,000 cancer deaths are due to smoking, sun exposure, poor diet, alcohol, inadequate exercise or being overweight.

Fortunately, there are a number of simple lifestyle changes you can make to help reduce your risk of cancer such as:

  • Maintaining a healthy weight
  • Eat a healthy diet
  • Regular exercise
  • Quitting smoking
  • Reducing alcohol intake
  • Being SunSmart
  • Get checked

Read more about the seven steps to reducing your cancer risk in Cancer Council’s cancer prevention lifestyle fact sheets.

Read full article and link to resources

” The review shows that cultural safety in service provision, increased participation in breast, bowel and cervical screening and reduction in risk factors will improve outcomes for cancer among Aboriginal and Torres Strait Islander people.

The good news is that many cancers are considered to be preventable. Lung cancer is the most commonly diagnosed cancer among Aboriginal and Torres Strait Islander people, followed by breast cancer, bowel cancer and prostate cancer.

Tobacco smoking is still seen as the greatest risk factor for cancer’.


“Aboriginal and Torres Strait Islander Community Controlled Health Services

Aboriginal and Torres Strait Islander Community Controlled Health Services are located in all jurisdictions and are funded by the federal,state and territory governments and other sources [91].

They are planned and governed by local Aboriginal and Torres Strait and Torres
Strait Islander communities and aim to deliver holistic and culturally appropriate health and health-related services.

Services vary in the primary health care activities they offer. Possible activities include: diagnosis and treatment of illness or disease; management of chronic illness; transportation to medical appointments; outreach clinic services; immunisations; dental services; and dialysis services.

Aboriginal and Torres Strait Islander cancer support groups have been identified as important for improving cancer awareness and increasing participation in cancer screening services [92].

Aboriginal women attending these support groups have reported an increased
understanding of screening and reported less fear and concern over cultural appropriateness, with increases in screening rates [19].

Support groups have also been found to help in follow up and ongoing care for cancer survivors [19, 93], particularly where they are shaped to meet the needs of Aboriginal and Torres Strait Islander people [73, 94].”

See Page 12 of 2018 Review

Download Review+of+cancer+among+Aboriginal+and+Torres+Strait+Islander+people

The Australian Indigenous HealthInfoNet (HealthInfoNet) at Edith Cowan University published a in 2018 Review of cancer among Aboriginal and Torres Strait Islander people.

The review, written by University of Western Australia staff (Margaret Haigh, Sandra Thompson and Emma Taylor), in conjunction with HealthInfoNet staff (Jane Burns, Christine Potter, Michelle Elwell, Mikayla Hollows, Juliette Mundy), provides general information on factors that contribute to cancer among Aboriginal and Torres Strait Islander people.

It provides detailed information on the extent of cancer including incidence, prevalence and survival, mortality, burden of disease and health service utilisation.

This review discusses the issues of prevention and management of cancer, and provides information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people.

The review provides:

  • general information on factors (historical/protective/risk) that contribute to cancer among Aboriginal and Torres Strait Islander people
  • detailed information on the extent of cancer among Aboriginal and Torres Strait Islander people, including: incidence, prevalence and survival data; mortality and burden of disease and health service utilisation
  • a discussion of the issues of prevention and management of cancer
  • information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people
  • a conclusion on the possible future directions for combating cancer in Australia

Selected Extract

2018 Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia is released
2016 National Framework for Gynaecological Cancer Control is released
2015 First National Aboriginal and Torres Strait Islander Cancer Framework is released
2015 Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan is released
2014 Second Cancer Australia Strategic Plan 2014–2019 is published
2013 First National Aboriginal and Torres Strait Islander Health Plan 2013–2023 is published
2011 First Cancer Australia Strategic Plan 2011–2014 is published
2008 National Cancer Data Strategy for Australia is released
2003 Report Optimising Cancer Care in Australia is published
1998 First National health priority areas cancer control report is published
1996 Cancer becomes one of four National health priority areas (NHPA)
1988 Health for all Australians report is released
1987 First National Cancer Prevention Policy for Australia is published

Concluding comments

Despite considerable improvements in cancer detection and treatment over recent decades, Aboriginal and Torres Strait Islander people diagnosed with cancer generally experience poorer outcomes than non-Indigenous people for an equivalent stage of disease [2797]. This is highlighted by statistics which showed that, despite lower rates of prevalence and hospitalisation for all cancers combined for Aboriginal and Torres Strait Islander people compared with non-Indigenous people, between 1998 and 2015, the age-standardised mortality rate ranged from 195 to 246 per 100,000 while the rate for non-Indigenous people decreased from 194 to 164 per 100,000 [2].

Furthermore for 2007–2014, while 65% of non-Indigenous people had a chance of surviving five years after receiving a cancer diagnosis, only 50% of Aboriginal and Torres Strait Islander people did [2].

The disparities are particularly pronounced for some specific cancers – for lung cancer the age-standardised incidence rate for Aboriginal and Torres Strait Islander people was twice that for non-Indigenous people, while for cervical cancer the rate was 2.5 times the rate for non-Indigenous people for 2009–2013 [2].

The factors contributing to these poorer outcomes among Aboriginal and Torres Strait Islander people are complex. They reflect a broad range of historical, social and cultural determinants and the contribution of lifestyle and other health risk factors [6], combined with lower participation in screening programs, later diagnosis, lower uptake and completion of cancer treatment, and the presence of other chronic diseases [2798155]. Addressing the various factors that contribute to the development of cancer among Aboriginal and Torres Strait Islander people is important, but improvements in some of these areas, particularly in reducing lifestyle and behavioural risk factors, are likely to take some time to be reflected in better outcomes.

Current deficiencies in the prevention and management of cancer suggest there is considerable scope for better services that should lead to improvements in the short to medium term. Effective cancer prevention and management programs that are tailored to community needs and are culturally appropriate are vital for the current and future health of Aboriginal and Torres Strait Islander people [5657]. Providing effective cancer prevention and management also requires improved access to both high quality primary health care services and tertiary specialist services. Effective and innovative programs for the prevention and management of cancer among Aboriginal and Torres Strait Islander people do exist on an individual basis and, in some cases, the efforts made to engage Aboriginal and Torres Strait Islander people in screening programs, in particular, are impressive. However, a more coordinated, cohesive national approach is also required.

Reducing the impact of cancer among Aboriginal and Torres Strait Islander people is a crucial aspect in ‘closing the gap’ in health outcomes. The National Aboriginal and Torres Strait Islander cancer framework [56] may be an important first step in addressing the current disparity in cancer outcomes and raises the probability of real progress being made. Cancer Australia has recently released the Optimal Care pathway for Aboriginal and Torres Strait Islander people which recommends new approaches to cancer care and with the aim of reducing disparities and improving outcomes and experiences for Aboriginal and Torres Strait Islander people with cancer [156]. As encouraging as these developments are, substantial improvements will also depend upon the effective implementation of comprehensive strategies and policies that address the complexity of the factors underlying the disadvantages experienced by Aboriginal and Torres Strait Islander people.

Action beyond the health service sector that addresses the broader historical, social and cultural determinants of health are also required if real progress is to be made [6]


NACCHO Aboriginal Children’s Health #BacktoSchool : What our kids eat can affect not only their physical health but also their mood, mental health and learning

“When kids eat a healthy diet with a wide variety of fruit and vegetables in that diet, they actually perform better in the classroom.​     

They’re going to have better stamina with their work, and at the end of the day it means we’ll get better learning results which will impact on them in the long term.”

Marlborough Primary School principal

We know that fuelling children with the appropriate foods helps support their growth and development.

But there is a growing body of research showing that what children eat can affect not only their physical health but also their mood, mental health and learning.

The research suggests that eating a healthy and nutritious diet can improve mental health¹, enhance cognitive skills like concentration and memory²‚³ and improve academic performance⁴.

In fact, young people that have the unhealthiest diets are nearly 80% more likely to have depression than those with the healthiest diets

Continued Part 1 Below

Aboriginal and Torres Strait Islander people suffer increased risk of chronic disease such as type 2 diabetes and heart disease.

Eating healthy food and being physically active lowers your risk of getting kidney disease and type 2 diabetes, and of dying young from heart disease and some cancers.

Being a healthy weight can also makes it easier for you to keep up with your family and look after the kids, nieces, nephews and grandkids. “

Continued Part 2 Below

Part 1

Children should be eating plenty of nutritious, minimally processed foods from the five food groups:

  1. fruit
  2. vegetables and legumes/beans
  3. grains (cereal foods)
  4. lean meat and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
  5. milk, yoghurt, cheese and/or their alternatives.

Consuming too many nutritionally-poor foods and drinks that are high in added fats, sugars and salt, such as lollies, chips and fried foods has been connected to emotional and behavioural problems in children and adolescents⁵.

In fact, young people that have the unhealthiest diets are nearly 80% more likely to have depression than those with the healthiest diets¹.

Children learn from their parents and carers. If you want your children to eat well, set a good example. If you help them form healthy eating habits early, they’re more likely to stick with them for life.

So here are some good habits to start them on the right path.

Eat with your kids, as a family, without the distraction of the television. Children benefit from routines, so try to eat meals at regular times.

Make sure your kids eat breakfast too – it’s a good source of energy and nutrients to help them start the day. Good choices are high-fibre, low-sugar cereals or wholegrain toast. It’s also a good idea to prepare healthy snacks in advance for them to eat in between meals.

Encourage children to drink water or milk rather than soft drinks, cordial, sports drinks or fruit juice drinks – don’t keep these in the fridge or pantry.

Children over the age of two years can be given reduced fat milk, but children under the age of two years should be given full cream milk.

Why are schools an important place to make changes?

Schools can play a key role in influencing healthy eating habits, as students can consume on average 37% of their energy intake for the day during school hours alone!6

A New South Wales survey found that up to 72% of primary school students purchase foods and drinks from the canteen at least once a week7. Also, in Victoria, while around three-quarters (77%) of children meet the guidelines for recommended daily serves of fruit, only one in 25 (4%) meet the guidelines for recommended daily serves of vegetables8; and discretionary foods account for nearly 40 per cent of energy intake for Victorian children9.

It’s never too late to encourage healthier eating habits – childhood and adolescence is a key time to build lifelong habits and learn how to enjoy healthy eating.

Get started today

You can start to improve students’ learning outcomes and mental wellbeing by promoting healthy eating throughout your school environment.

Some ideas to get you started:

This blog article was originally published on Healthy Eating Advisory Service . 

Part 2

Aboriginal and Torres Strait Islander people suffer increased risk of chronic disease such as type 2 diabetes and heart disease.

Eating healthy food and being physically active lowers your risk of getting kidney disease and type 2 diabetes, and of dying young from heart disease and some cancers.

Being a healthy weight can also makes it easier for you to keep up with your family and look after the kids, nieces, nephews and grandkids.

Aboriginal and Torres Strait Islander people may find it useful to chose store foods that are most like traditional animal and plant bush foods – that is, low in saturated fat, added sugar and salt – and use traditional bush foods whenever possible.

The Healthy Weight Guide provides information about maintaining and achieving a healthy weight.

It tells you how to work out if you’re a healthy weight. It lets you know up-to-date information about what foods to eat and what foods to avoid and what and how much physical activity to do. It gives you tips on setting goalsmonitoring what you dogetting support and managing the challenges.

There are also tips on how to eat well if you live in rural and remote areas.

The national Live Longer! Local Community Campaigns Grants Program supports Indigenous communities to help their people to work towards and maintain healthy weights and lifestyles. For more information, see Live Longer!.

Part 3 Parents may not always realise that their children are not a healthy weight.

If you think your child is underweight, the following information will not apply to your situation and you should seek advice from a health professional for an assessment.

If you think your child is overweight you should see your health professional for an assessment. However, if you’re not sure whether your child is overweight, see if you recognise some of the signs below. If you are still not sure, see your health professional for advice.

Overweight children may experience some or all of the following:

  • Having to wear clothes that are too big for their age
  • Having rolls or skin folds around the waist
  • Snoring when they sleep
  • Saying they get teased about their weight
  • Difficulty participating in some physically active games and activities
  • Avoiding taking part in games at school
  • Avoiding going out with other children

Signs that a child is at risk of becoming overweight, if they are not already, include:

  • Eating lots of foods high in saturated fats such as pies, pasties, sausage rolls, hot chips, potato crisps and other snacks, and cakes, biscuits and high-sugar muesli bars
  • Eating take away or fast food meals more than once a week
  • Eating lots of foods high in added sugar such as cakes, biscuits, muffins, ice-cream and deserts
  • Drinking sugar-sweetened soft drinks, sports drinks or cordials
  • Eating lots of snacks high in salt and fat such as hot chips, potato crisps and other similar snacks
  • Skipping meals, including breakfast, regularly
  • Watching TV and/or playing video games or on social networks for more than two hours each day
  • Not being physically active on a daily basis.

For more information:

References for Part 1

1 Jacka FN, et al. Associations between diet quality and depressed mood in adolescents: results from the Australian Healthy Neighbourhoods Study. Aust N Z J Psychiatry. 2010 May;44(5):435-42.
2 Gómez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568-578. Retrieved from
3 Bellisle, F. (2004). Effects of diet on behaviour and cognition in children. British Journal of Nutrition, 92(2), S227–S232
4 Burrows, T., Goldman, S., Pursey, K., Lim, R. (2017) Is there an association between dietary intake and academic achievement: a systematic review. J Hum Nutr Diet. 30, 117– 140 doi: 10.1111/jhn.12407.
5 Jacka FN, Kremer PJ, Berk M, de Silva-Sanigorski AM, Moodie M, Leslie ER, et al. (2011) A Prospective Study of Diet Quality and Mental Health in Adolescents. PLoS ONE 6(9): e24805.
6 Bell AC, Swinburn BA. What are the key food groups to target for preventing obesity and improving nutrition in schools? Eur J Clin Nutr2004;58:258–63
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9 Department of Health and Human Services 2016, Victoria’s Health; the Chief Health Officer’s report 2014, State Government of Victoria, Melbourne.