Outcome 1: Aboriginal and Torres Strait Islander people enjoy long and healthy lives

Target 1: Close the Gap in life expectancy within a generation, by 2031

Minister responsible

Minister for Health and Aged Care, Assistant Minister for Indigenous Health

Productivity Commission national progress against the target

The path forward

The strengths and leadership of First Nations peoples and communities are critical to driving all First Nations health and wellbeing actions to close the gap in life expectancy.

First Nations health leaders co-designed the National Aboriginal and Torres Strait Islander Health Plan 2021–2031 (Health Plan) and the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021–2031 (Workforce Plan) in partnership with the Commonwealth.

Through these plans, First Nations decision-making sets the strategic priorities to close the gap in life expectancy, including the allocation of $4.8 billion over four years (2022–23 to 2025–26) through the Indigenous Australians’ Health Programme. Both plans give practical effect to the Priority Reforms and embed First Nations leadership in governance and accountability mechanisms within the health sector. These plans will contribute to ensuring First Nations access to data to support shared decision‑making is achieved.

The Commonwealth will continue to support and grow the Aboriginal Community Controlled Health Services (ACCHS) sector. As outlined in the Core Services and Outcomes Framework, this will address complex First Nations health needs through a wide range of culturally safe and responsive services, and delivers better health and wellbeing outcomes for First Nations populations compared to mainstream primary care services.

To eliminate racism and build the capacity of mainstream settings to deliver culturally safe, trauma‑informed, and appropriate health care to First Nations peoples, the Commonwealth will support and grow the First Nations health workforce across all levels, roles, and locations. This workforce is vital to service capacity in ACCHS and ensuring the mainstream health system is effective, accessible, and culturally safe.

The Commonwealth recognises that health is a holistic concept that encompasses the cultural and social determinants of health across the life course. Actions will therefore prioritise health promotion, prevention and early intervention for the conditions that disproportionately impact First Nations populations.

In recognition of the key role that older First Nations Australians play in their communities, there will be a particular focus on healthy ageing and the diverse and changing needs of older First Nations peoples. This includes ensuring the aged care system is accessible, culturally safe and responsive, with services delivered close to families, communities and Country.

Priority actions

Supporting and growing the community-controlled health sector

Work has commenced to prioritise the delivery of care through ACCHS by:

• Funding the delivery of 17 critical ACCHS infrastructure projects in key high-need and remote areas across the country to support health care access for First Nations communities
• Working with the ACCHS sector to design and implement a transparent, needs-based and sustainable national approach to expand access to comprehensive primary health care, including transitioning services to Aboriginal community control.

Mainstream health services

The Commonwealth will make the mainstream health system more culturally safe and responsive by:

• Ensuring First Nations priorities are embedded in mainstream health reforms, including the Medicare Taskforce
• Working with states and territories to address racism and embed cultural safety across the health care system, in alignment with Priority Reform Three
• Prioritising First Nations priorities in the Improving Care Pathways work commissioned by National Cabinet with states and territories.

First Nations workforce

The Commonwealth is growing and strengthening the First Nations health workforce by:

• Working in partnership with the National Aboriginal Community Controlled Health Organisation (NACCHO) to train up to 500 First Nations health workers through the First Nations Health Workers Traineeship Program in alignment with Priority Reform Two
• Implementing Workforce Plan actions and providing annual progress reports.

Holistic health approaches

The Commonwealth is prioritising cultural determinants and social determinants approaches in preventive health, health promotion and early intervention action for chronic diseases by:

• Funding up to 30 four-chair dialysis units and two dialysis treatment buses to allow more First Nations peoples to receive culturally safe care closer to home and on Country
• Increasing funding to NACCHO to help prevent acute rheumatic fever and improve evidence‑based care of First Nations peoples with rheumatic heart disease through the Rheumatic Fever Strategy
• Improving access to primary health care and referral services in rural and remote settings
• Increasing distribution and availability uptake of community-led preventive health, health promotion and early intervention activities
• Implementing the Workforce Plan to support the professional development and growth of the First Nations health workforce in these areas.

Rapid point-of-care cervical screening tests and follow-up

The Commonwealth is providing rapid point-of-care cervical screening tests and follow up in Aboriginal and Torres Strait Islander communities. This will:

• Overcome delays in cervical cancer screening
• Support prevention
• Remove the requirement for women to travel from Country to follow up.

This initiative also aims to increase access and participation in cervical screening for First Nations women who are generally under-screened and more likely to develop cervical cancer than women who are regular screeners.

Indigenous media strategy

The Commonwealth, through the Australian Digital Health Agency's Communications and Marketing Team, is ensuring comprehensive coverage of First Nations communities by:

• Developing an Indigenous media strategy
• Implementing an ongoing media outreach program.

This action is aimed at driving awareness and uptake of key digital health technology in First Nations communities. Utilising existing budgets and resources, the audit and strategy will be delivered by June 2023, with delivery to commence from July 2023.

AFL in First Nations communities in Northern Territory

The Commonwealth is supporting the AFL through $2.2 million in funding to boost physical activity amongst First Nations communities in the Northern Territory. The program will address prevalence rates of health risk factors (physical activity) by:

• Focusing on increasing participation amongst Indigenous school-aged women and girls across the Northern Territory in AFL training and competitions
• Promoting the physical and mental health benefits of participating in sport.

Supporting healthy ageing

In 2023, the Commonwealth is continuing to implement the recommendations of the Royal Commission into Aged Care Quality and Safety by:

• Increasing the First Nations aged care workforce by providing trusted face‑to‑face support and assisting older First Nations people and families better navigate and access care
• Upgrading existing buildings and construct purpose-built care services and essential staff housing, including funding to support ACCHS to expand into aged care
• Increasing delivery of National Aboriginal and Torres Strait Islander Flexible Care Services to support delivery of quality and culturally safe aged care services to older First Nations peoples
• Assisting First Nations organisations with capacity for governance, business, training and leadership
• Assisting mainstream organisations build their capacity to deliver culturally safe aged care services to older First Nations peoples.

Summary of new actions

*A full appendix of new and existing measures being undertaken by the Commonwealth to support Closing the Gap efforts is on the NIAA website, at Closing the Gap implementation measures.