NACCHO Aboriginal Health #history : Cabinet papers 1992-93: Aboriginal deaths in custody inquiry prompted $400m package

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“ The trend will ­inevitably continue unless there is decisive intervention now” and it considered measures costing $570 million across five years to ­address “the underlying causes, ­including lack of employment ­opportunity, a low level of economic development, inadequate education, welfare dependency, appalling health and cultural deprivation”.

Too many face a bleak future as a result of poor living conditions, locational disadvantage and discrimination, substance abuse and lack of ­opportunity for constructive ­activity as major causes of Aboriginal young people’s conflict with the law and justice systems”.

From the report of the Royal Commission into Aboriginal Deaths in Custody, delivered in 1991 after four years of work, was described in a March 1992 cabinet briefing as “the most searching analysis of Aboriginal society ever undertaken and one of the most significant social documents of con­temporary Australia”.

Image above  : See Background facts and timeline

Article originally published 2 Jan 2017 The Australian

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Chairman of the Council for Aboriginal Reconciliation Patrick Dodson, centre, with Prime Minister Paul Keating and Minister for Aboriginal and Torres Strait Islander Affairs Robert Tickner, February 1992. Picture: National Archives of Australia
2 of 17 see article 2 below

The commission inquired into 99 deaths, the circumstances that gave rise to them and their underlying causes, and came back with 339 recommendations, two-thirds about changes needed across the criminal justice system.

The urgency was underscored by the 25 deaths since the report was concluded, and a 25 per cent increase in indigenous imprisonment rates over four years.

The centrepiece was an expansion of the federal Community Development Employment Projects scheme, which “provides not only employment but a basis for communities’ economic and social development. Its emphasis on self- management and self-reliance provides hope and boosts morale for communities that have little or no access to the labour market”.

The government’s comprehensive response to the commission was to be tailored to youth, with more than 40 per cent of all indigenous Australians aged under 15, and 50 per cent younger than 20.

“Too many face a bleak future as a result of poor living conditions, locational disadvantage and discrimination,” cabinet was told, with the commission identifying “substance abuse and lack of ­opportunity for constructive ­activity as major causes of Aboriginal young people’s conflict with the law and justice systems”.

Indigenous affairs minister Robert Tickner — also then minister assisting the prime minister for Aboriginal reconciliation — and Brian Howe, assistant social justice minister, also sought funding for land acquisition.

This was the hardest element of the package to sell and was eventually ruled out in the $400m deal that was struck — although Mr Tickner says now that it was not the key element and came to fruition in a different way with the passage the following year of the Native Title Act.

The Departments of Finance and Treasury objected to the ­proposal.

Robert Tickner calls on PM to take control of relationship with Indigenous people

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Article 2

Australia’s longest-serving indigenous affairs minister has called for Malcolm Turnbull to seize control of a moribund relationship with Aboriginal and Torres Strait Islanders, describing the state of indigenous disadvantage as “truly a national embarrassment of successive governments”.

Robert Tickner, who held the portfolio for six years in the Hawke and Keating governments and was instrumental in both the 1992 response to the Royal Commission into Aboriginal Deaths in Custody and the 1993 native title legislation following the High Court’s Mabo ruling, said the matter was “not a job for an indigenous affairs minister”.

Instead it must be tackled, he said, by “a prime minister who can command the authority of the

nation and his own agencies to engender a whole-of- government response”.

Mr Tickner called on the Prime Minister to establish an immediate audit of any progress on the royal commission’s 339 recommendations, which he said “overwhelmingly … have not been implemented, either by the national government or by successive state and territory governments; worse still, governments of all political persuasions (have) covered up that failure”.

He said Mr Turnbull should use the 50th anniversary of the referendum which gave the Commonwealth power in indigenous affairs, on May 27, to “capture the moment … to announce major policy commitments to address these issues”.

“I desperately hope he seizes the moment on this … but he needs to do so in a way that enjoys strong support from Aboriginal and Torres Strait Islander people as well as the opposition, as the

referendum did almost 50 years ago,” he said, in remarks unveiling select cabinet papers from the 1992-93 Keating government.

“Keating did it on Mabo, someone’s got to do it now,” he said, describing indigenous affairs policy as “ineffectual, half-hearted and (without) the full resources of the Commonwealth behind it, which was envisaged by the ’67 referendum”.

He called for bipartisan support, saying he believed Mr Turnbull was “a good and decent person who wants to do the right thing in Aboriginal affairs — but good intentions are not enough without the necessary leadership to generate real change” and said the issue was “above party politics, and one where Mr Turnbull and (Bill) Shorten could stand together”.

A key shift, he said had to be moving away from “the old paternalistic way” of dealing with indigenous people and organisations, with the royal commission noting in 1991 that “unless those underlying issues were addressed there would be no change; it’s about the marginalisation of Aboriginal people which contributed to that incarceration”.

He said Mr Keating had “showed great political courage to deliver a just outcome for Aboriginal and Torres Strait Islander people after 204 years of the legal system denying their rights with that pernicious doctrine of terra nullius”. The former prime minister’s “diligence and dedication” over the 18 months following the High Court’s 1992 Mabo ruling establishing native title in the face of “the non-stop, torrid and at times vitriolic public attacks” had defined a critical time in Australian history, he said.

“It’s fair to say the reconciliation process has helped shape modern Australia,” Mr Tickner said. “Most important, Keating was the one who put meat on the bones of the reconciliation process through the Mabo response.”

GALLERY: 1992-93 cabinet papers

He said the Keating government had welcomed the High Court’s decision because it “removed a great barrier to reconciliation,” but that it knew from the outset “the huge challenge that lay ahead, with state and territory governments having traditional responsibility for and management of (the) issues, and an Australian community which did not yet understand the implications of the high court decision”.

Six months on from Mabo, he said, Mr Keating’s famous Redfern Park speech acknowledging responsibility for the dispossession of indigenous Australians “set the bar very high for the government to respond in a principled way to the judgment, and to meet the expectations of the reconciliation process”.

The cabinet papers reveal details of the complexity introduced with the Wik claim in June 1993, with the cabinet by then having considered nine distinct approaches to legislation. “We considered but rejected options relating to extinguishment of native title (it would lead to deep domestic divisions and strong international condemnation) and entrenchment (amending the constitution to put land under native title beyond the control of parliament raises very major issues,” they reveal.

In the end the decision was made to “feel the way forward” but Mr Tickner said many younger Australians now “would have no real appreciation of the vitriol, intolerance and scaremongering that was perpetuated in the debate”, some of which “makes Donald trump’s election campaign look like the free-flowing milk of human kindness”.

He said that during the cabinet process it “very often … got very lonely for an Aboriginal and Torres Strait Islander Minister, as some of my other colleagues were fierce advocates either for the interests represented in their portfolios or in some cases for a state Labor government. I frequently clashed both with those ministers and public servants who held similar views. They were wrong on both history and principles”.

He said Mr Keating had “cemented his place in history” by seeking to reach “a negotiated outcome with Aboriginal leadership” rather than pushing for a deal with the states that failed to meet Aboriginal aspirations.

“This was the first time since 1788 when the Aboriginal people of the land were in face-to-face, genuine negotiation with a leader of a state or territory government,” he said, singling out then-

ATSIC chair Lowitja O’Donoghue for being “magnificent as a leader” who “set a cracking pace for the younger members of the negotiating team”.

The result, he said, was an outcome “that both respected the high court decision and gave important additional rights and interests, while making sure that the rights of non-indigenous Australians were protected”, before finally being “painstakingly negotiated through the senate” as the Native Title Act on December 21, 1993.

However it came at considerable personal cost, he said, including being sent a dead rat in the mail, having his electorate office partly destroyed in an arson attack and receiving repeated death threats.

He also revealed a tightly guarded secret: during the tumult of negotiations in early 1993 he was for the first time “reunited with my birth mother on the steps of the Sydney Opera House, and began a journey as transformative for me as the public journey was as Australia travelled the Mabo response”.

He described John Howard’s 1998 amendments to the native title act, in response to the Wik

decision and which put restrictions on claims, as “regrettable”, saying he was “sorry for John because I think he did some other important things, like gun control, but I don’t think Aboriginal and Torres Strait Islander affairs was where he left a mark politically, and I’m sad about that”.

NACCHO Aboriginal Health #closethegap Report: ABS Cause of deaths statistics

 

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Aboriginal and Torres Strait Islander Causes of Death

The top three WHO leading causes of death for Aboriginal and Torres Strait Islander Australians in 2014 were Ischaemic heart diseases (I20-I25), Diabetes (E10-E14) and Chronic lower respiratory diseases (J40-J47).

Compared to the non-Indigenous population, death rates were 1.7 times higher for Ischaemic heart diseases (I20-I25), 5.9 times higher for Diabetes (E10-E14) and 3.0 times higher for Chronic lower respiratory diseases (J40-J47) for Aboriginal and Torres Strait Islander Australians.

Further information can be found in the Deaths of Aboriginal and Torres Strait Islander section of this publication.

There were 2,914 deaths registered across Australia in 2014 where the deceased person was identified as being of Aboriginal and Torres Strait Islander origin. This represents 1.9% of all deaths registered.

The remainder of this chapter is focussed on the 2,730 deaths recorded in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Data for Victoria, Tasmania and the Australian Capital Territory have been excluded in line with national reporting guidelines (for information on issues with Aboriginal and Torres Strait Islander identification, see Explanatory Notes 57-66). When considering these five jurisdictions, the age-standardised death rate for Aboriginal and Torres Strait Islander Australians was 982.4 per 100,000.

Closing the Gap

The Council of Australian Governments’ (COAG) National Indigenous Reform Agreement is a partnership between all levels of government to work with Aboriginal and Torres Strait Islander communities to achieve the target of closing the gap in Indigenous disadvantage. One of the targets is to ‘close the gap in life expectancy within a generation’. The ABS provides COAG with mortality data that supports measurement of progress towards this.

This chapter provides death counts, age-standardised death rates (SDRs), and comparisons in numbers and rates between Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians by cause of death. Data on infant mortality is also included.

Data Quality Issues

A variety of measures of mortality (including age-specific death rates, median age at death, and infant mortality rates) indicate that the mortality level of Aboriginal and Torres Strait Islander persons is substantially higher than that of the non-Indigenous population.

The exact scale of difference between the mortality of Aboriginal and Torres Strait Islander persons and non-Indigenous persons is difficult to establish conclusively. Some of the issues affecting the reporting of Aboriginal and Torres Strait Islander mortality include mis-identification of Aboriginal and Torres Strait Islander deaths, unexplained changes in the number of people recorded as being Aboriginal and Torres Strait Islander Australians in different data collections and over time, the incorrect use of a standard Aboriginal and Torres Strait Islander status question, changes in administrative processes, and not stated Aboriginal and Torres Strait Islander status. As a result, changes in numbers of registered Aboriginal and Torres Strait Islander deaths over time may not accurately reflect changes in the numbers of Aboriginal and Torres Strait Islander deaths. For more information on this and other issues to consider when undertaking analysis of Aboriginal and Torres Strait Islander deaths see Explanatory Notes 57-66.

The ABS works collaboratively with the Registrars of Births, Deaths and Marriages through the National Civil Registration and Statistics Improvement Committee. This Committee is in the process of developing an Aboriginal and Torres Strait Islander Data and Statistics Improvement Strategy for births and deaths. This strategy will identify key initiatives to be progressed by the Committee with the support of other stakeholders (government and non-government) to improve the quality and coverage of civil registration and vital statistics in Australia as it relates to Aboriginal and Torres Strait Islander people.

Further care should also be taken when interpreting deaths of Aboriginal and Torres Strait Islander persons for Queensland for 2010. An initiative undertaken by the Queensland Registry of Births, Deaths and Marriages resulted in the registration of 374 outstanding deaths from 1992-2006. Of these, approximately 76% were deaths of Aboriginal and Torres Strait Islander persons. For further information see Technical Note: Retrospective Deaths by Causes of Death, Queensland, 2010 and the Deaths, Australia, 2010 Technical Note: Registration of Outstanding Deaths, Queensland, 2010.

About cause of death statistics

Causes of death data are a significant and important input to health and social policy formulation and planning as well as health related research and analysis. For example, causes of death data provide an insight into the diseases and factors contributing to life expectancy, potentially avoidable deaths, years of life lost and leading causes of death. Causes of death statistics, together with statistics pertaining to births and deaths, make up the ’vital statistics’ component of Australia’s civil registration system, providing an important foundation for both population statistics as well as health statistics. Australia, as a member state of the World Health Organization (WHO), supplies data annually to the WHO on deaths by age, sex and cause of death, as compiled from the civil registration system by the Australian Bureau of Statistics.

In Australia, causes of death statistics are recorded as both underlying causes and multiple causes of death. The underlying cause is the single disease or injury which began the sequence of conditions that resulted in death. Unless stated otherwise, causes of death statistics presented by the ABS refer to the underlying cause. For further information on the way causes of death are compiled, see the Explanatory Notes in this publication.

Deaths

There were 153,580 deaths registered in Australia in 2014, 5,902 more than the number registered in 2013 (147,678). There were more male deaths (78,341) registered in 2014 than female deaths (75,239), resulting in a sex ratio of 104.1 male deaths for every 100 female deaths.

Leading causes of death

The leading causes of death were Ischaemic heart diseases (I20-I25), Dementia, including Alzheimer’s disease (F01, F03, G30), Cerebrovascular diseases (including strokes) (I60-I69), Cancer of the trachea, bronchus and lung (C33, C34), and Chronic lower respiratory diseases (J40-J47). These accounted for over one-third of all deaths.

Although the five leading causes of death were the same for males as females in 2014, there were also key differences between the sexes.

          • More males than females died from Ischaemic heart diseases (I20-I25) (11,082 males; 9,091 females) and from Cancer of the trachea, bronchus and lung (C33, C34) (4,947 males; 3,304 females).

 

        • More females than males died from Dementia, including Alzheimer’s disease (F01, F03, G30) (7,859 females; 4,106 males) and Cerebrovascular diseases (I60-I69) (6,486 females; 4,279 males).

The diagram below shows, in order, the five leading causes of death for the total population. Each leading cause is shown to account for a proportion of all deaths calculated separately for males and females. The leading cause of death for all people, Ischaemic heart diseases (I20-I25), accounted for one in seven male deaths and one in eight female deaths. The second leading cause, Dementia, including Alzheimer’s disease (F01, F03, G30) accounted for one in 19 male deaths and one in 10 female deaths. Dementia, including Alzheimer’s disease (F01, F03, G30) was the second leading cause for females, and the fifth leading cause for males. Cancer of the trachea, bronchus and lung (C33, C34) was the second leading cause for males accounting for one in 16 deaths, and was the fifth leading cause for females accounting for one in 23 deaths. Further information can be found in the Leading Causes of Death section in this publication.

Leading causes as a proportion of all male and female deaths, 2014Diagram: Leading causes as a proportion of all male and female deaths, 2014.

Causes of death by age

Leading causes of death vary across age groups.

        • Among those aged 15 to 44, the leading causes of death were Intentional self-harm (suicide) (X60-X84), Accidental poisonings (including drug overdoses) (X40-X49) and Land transport accidents (V01-V89).
        • Among those aged 45 to 74, the most common causes of death were Ischaemic heart diseases (I20-I25), Cancer of the trachea, bronchus and lung (C33, C34) and Chronic lower respiratory diseases (J40-J47).
        • Among those aged 75 and over, the most common causes of death were Ischaemic heart diseases (I20-I25), Dementia, including Alzheimer’s disease (F01, F03, G30), and Cerebrovascular diseases (I60-I69).

Further information can be found in the Leading Causes of Death section in this publication.

Years of Potential Life Lost

Years of Potential Life Lost measures the extent of ‘premature’ mortality. While a cause of death may have a lower incidence than that of another, its impact when measured in terms of premature death may be greater, as a result of that cause affecting a younger demographic.

Intentional self-harm (X60-X84) deaths accounted for 97,066 years of potential life lost, the highest of all leading causes in 2014. Deaths from Dementia, including Alzheimer’s disease (F01, F03, G30) accounted for only 6,710 years of potential life lost. A key reason for this difference is that the median age at death for Intentional self-harm (X60-X84) in 2014 was 44.2 years. In comparison, the median age at death for Dementia, including Alzheimer’s disease (X60-X84) was 88.4 years. The median age at deaths for all causes in 2014 was 81.8 years.

Potentially Avoidable Mortality

Potentially avoidable deaths comprise deaths from certain conditions that are considered avoidable given timely and effective health care. In 2014, 26,283 Australians died from potentially avoidable causes of death.

Among people who died between 15 and 44 years of age, 69.8% of deaths were considered to be potentially avoidable in 2014. Some of the leading potentially avoidable causes included Intentional self-harm (X60-X84), Accidental poisonings (X40-X49) and Land transport accidents (V01-V89).

Approximately half (46.9%) of those who died aged 45-74, died of causes considered to be potentially avoidable. The most common potentially avoidable causes for this age group were Ischaemic heart diseases (I20-I25), Chronic obstructive pulmonary disease (J40-J44) and Colon, sigmoid, rectum and anus cancer (C18-C21).

Further information can be found in the Potentially Avoidable Mortality section in this publication.

Multiple Causes of Death

Multiple causes are all causes and conditions reported on the death certificate that contributed to, were associated with, or were the underlying cause of the death (see the Glossary for further details). Looking at these multiple causes gives a more complete picture of the diseases and conditions affecting the health of the Australian population. In 2014 there was an average of 3.3 causes for each death.

As the population ages, deaths are likely to feature chronic conditions with multiple comorbidities. Approximately two-thirds of deaths (65.9%) in people aged over 75 years in 2014 had three or more conditions certified by a doctor or coroner. For people under 45 years of age, 53.0% of deaths were reported with three or more conditions.

Deaths where the underlying cause is considered to be chronic, are generally more likely to have a greater number of conditions reported on the death certificate than deaths due to other causes. In 2014, for deaths with an underlying cause of Type 2 diabetes (E11), there was an average of 5.5 conditions reported with each death, the most common of these being Diseases of the circulatory system (I00-I99).

Further information can be found in the Multiple Causes of Death section in this publication.

Aboriginal and Torres Strait Islander Causes of Death

The top three WHO leading causes of death for Aboriginal and Torres Strait Islander Australians in 2014 were Ischaemic heart diseases (I20-I25), Diabetes (E10-E14) and Chronic lower respiratory diseases (J40-J47).

Compared to the non-Indigenous population, death rates were 1.7 times higher for Ischaemic heart diseases (I20-I25), 5.9 times higher for Diabetes (E10-E14) and 3.0 times higher for Chronic lower respiratory diseases (J40-J47) for Aboriginal and Torres Strait Islander Australians.

Further information can be found in the Deaths of Aboriginal and Torres Strait Islander section of this publication.

Perinatal deaths

Changes were made to the coding of Perinatal deaths in 2013 which resulted in neonatal deaths being assigned only a ‘main condition in infant’ rather than an underlying cause of death. In the past year the ABS has led a process, working with coding specialists both internationally and nationally, to derive a supported method for coding an underlying cause for deaths certified using the Medical Certificate of Cause of Perinatal Death (MCCPD). This has resulted in a new coding method for neonatal deaths which has been implemented by the ABS.

Further information on changes to the Perinatal dataset can be found in Technical Note 2, Changes to Perinatal Death Coding.

ACKNOWLEDGEMENT

This publication draws extensively on information provided freely by the state and territory Registrars of Births, Deaths and Marriages, and the Victorian Department of Justice who manage the National Coronial Information System (NCIS). Their continued cooperation is very much appreciated: without it, the wide range of vitals statistics published by the ABS would not be available.

INQUIRIES

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 0701300 135 070.

NACCHO social policy news:Indigenous Australians a quarter of Australia’s prisoner population. It’s a social policy disaster.But could there be solution!

Prison

Firstly though, politicians and the public alike need to understand and admit that the current policy ethos, and its reliance of incarceration, is a failure, both socially and economically.

Australia spends $2.6 billion a year incarcerating adults

But could there  be  solution!

We invite our members to make comment see below

Reproduced from the DRUM : Paul Simpson and Michael Doyle

The continual rise in incarceration rates of Indigenous Australians represents nothing short of social policy disaster.

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If reducing the numbers of those in prison is to be achieved, then we need to end the reliance on incarceration and invest more into new thinking and rigorous research on non-incarceration alternatives.

Marking 20 years of monitoring since the Royal Commission into Aboriginal Deaths in Custody, the Australian Institute of Criminology finally released its ‘deaths in custody‘ report last Friday and the figures reaffirm the increasing over-representation of Indigenous persons in custody.

In 20 years rates have gone from one Indigenous person in seven incarcerated to one in four.

Indigenous persons make up 26 per cent of the prisoner population yet only constitute 2.5 per cent of the Australian population.

The over-representation of Indigenous persons in Western Australian prisons is the highest of any Indigenous group in the OECD.

Addressing Indigenous over-representation in custody requires new thinking and tested approaches to the offender population.

Firstly though, politicians and the public alike need to understand and admit that the current policy ethos, and its reliance of incarceration, is a failure, both socially and economically.

Australia spends $2.6 billion a year incarcerating adults. Punitive penal policies cost Australia big time.

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While happy to scrutinise the effectiveness and efficiencies of all other sectors and services, political authorities seem quite content to overlook the billions poured into the prison system.

The return on this ‘investment’ amounts to very little. It simply does not prevent re-offending.

Longitudinal studies show that two-in-five people are re-imprisoned within two-to-five years of release.

Those who advocate for new thinking beyond the current social policy failures have hailed Justice Reinvestment (JR) as one new approach.

Justice Reinvestment was introduced to the US in 2003 by the Open Society Institute and has subsequently been adopted in eleven US states.

It involves identifying geographic areas from where significant numbers of the incarcerated population emanate and investing in services in these areas.

Importantly, at the policy level JR aims to divert funds that would be spent on criminal justice matters (primarily incarceration) back into local communities to fund services that are said to address the underlying causes of crime, thus preventing people from engaging with the criminal justice system.

Detention under this model is seen as a last resort – for only the most dangerous and serious offenders.

The goal is to shift the culture away from imprisonment and to restoration within the community through restorative health, social welfare services, education-employment programs and programs to prevent offending.

The effectiveness of JR was reported on at the First National Summit on JR in Washington in 2010, where lawmakers from several American states discussed how they had enacted policies to avert projected prison growth, saving several hundred million dollars, while decreasing prisoner numbers and recidivism rates.

Australian scholars have reservations about the type of JR model adopted in some US states, specifically querying who controls and receives the funding. Is it the community-sector or another state agency?

Former Aboriginal and Torres Strait Islander Social Justice Commissioner Dr Tom Calma commended JR as a possible solution to Indigenous over-representation in Australia’s criminal justice system. Several other Australian commentators have followed suit.

Despite the increasing popularity of JR, Australia so far lacks evidence to support it beyond its appealing rhetoric and, some might argue, simplistic notion as a viable policy alternative.

Members of the Indigenous Offender Health Research Capacity Building Group (IOHR-CBG) and the Australian Justice Reinvestment Project based at the University of NSW have begun research efforts to address this paucity of information, .

Following two national Justice Reinvestment forums convened by IOHR-CBG member Dr Jill Guthrie, a three-year JR research project has begun at National Centre for Indigenous Studies.

Using a case study approach, the research explores the conditions, governance and cultural appropriateness of reinvesting resources otherwise spent on incarceration, into services to enhance juvenile offenders’ ability to remain in their community.

The Australian Justice Reinvestment Project is currently is examining JR models from overseas in order to provide a sound theoretical and practical foundation for the future development of JR strategies in Australia.\

There is also a Citizens’ Jury research project being run this year by IOHR-CBG researchers aimed at eliciting the values and priorities of a critically informed Australian community with respect to JR.

Citizens’ Juries have been used in various policy fields internationally, including in health in Australia. They involve bringing together group of randomly selected citizens, giving them a variety of evidence-based information on the issues to hand and asking them, as representatives of the community, about their preferences for certain policy options or priorities for resource allocation.

The project also assesses how the results of the Citizens’ Juries might influence the decision making of government policy makers.

Research of this nature is critical in order to imagine and test new and viable alternatives to incarceration. Unfortunately, the current amount invested in such research is minute.

As the recently-emerged adage says, a ‘tough on crime’ approach needs to be replaced by a ‘smart on crime’ approach. A new policy platform to justice is well overdue.

This platform must be informed by evidence and not the tired political populism that exploits the fears of the electorate if we are to ever make inroads in reducing the hugely disproportionate Indigenous incarceration rate in Australia.

Paul Simpson and Michael Doyle are research fellows with the Justice Health Research Program at the Kirby Institute, University of NSW, and are also members of the Indigenous Offender Health Research Capacity Building Group.