Executive Summary
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Improvements
Health
Between 2003 and 2011 there has been a small decrease (5%) in the burden of disease in the Indigenous Australian population (AIHW, 2016f). Most of this improvement came from decreases in deaths.
Between 1998 and 2015 there has been a significant decline in the mortality rate for Indigenous Australians (15%). Major contributors to this decline include circulatory diseases (declined by 43%), respiratory disease (24%) and kidney disease (47% decline between 2006 and 2015). Circulatory disease was the most common cause of death for Indigenous Australians (24% of deaths) during 2011–15.
Risk factors
The Indigenous current smoking rate declined significantly by 9 percentage points (from 51% to 42%) between 2002 and 2014–15 for those aged 15 years and over.
Between 2008 and 2014–15, the proportion of Indigenous Australians aged 15 years and over drinking at risky levels declined for both single occasion (from 38% to 31%) and for lifetime risk (from 19% to 15%).
Child and maternal health
There has been a significant decline in the mortality rate for Indigenous children aged 0–4 years (33%) between 1998 and 2015.
The low birthweight rate declined by 13% between 2000 and 2014 for babies born to Indigenous mothers and there has been a narrowing of the gap.
Smoking during pregnancy declined for Indigenous mothers between 2006 and 2014 (from 54% to 46%).
Health system
Medicare services claimed by Indigenous Australians have increased over the last decade, including increases in health assessments, chronic disease management items and overall GP care. The Indigenous rate of Medicare GP services claimed (6,623 per 1,000) is higher than the non-Indigenous rate (5,840 per 1,000).
Between 1 July 2010 and 30 June 2016, 17.9 million scripts were issued under the PBS Co-payment Measure to Indigenous Australians.
Episodes of care delivered through Aboriginal and Torres Strait Islander primary health care services have tripled (from 1.2 million in 1999–2000 to 3.5 million in 2014–15).
Social determinants
Between 2008 and 2014–15, the gap in the Year 12 or equivalent attainment rate for those aged 20–24 years has narrowed by 14.7 percentage points and the 2020 Council of Australian Governments (COAG) target is currently on track.
There have also been improvements in overcrowding, homelessness and home ownership over the last decade.
Concerns
Health
Indigenous Australians experienced a burden of disease that was 2.3 times the rate of non-Indigenous Australians in 2011 (AIHW, 2016f).
The life expectancy of Indigenous Australians has improved slightly in recent years but progress will need to accelerate if the target to close the gap in life expectancy by 2031 is to be met.
In 2014–15, 45% of Indigenous Australians aged 15 years and over reported a disability or restrictive long-term health condition.
Cancer death rates for Indigenous Australians have increased by 21% between 1998 and 2015, while rates for non-Indigenous Australians have declined (by 13%).
There has been no improvement in mortality rates for diabetes or injury between 1998 and 2015; and there was a significant increase in the Indigenous suicide rate (32%). In 2012–13, 11% of Indigenous adults had diabetes (3 times the non-Indigenous rate) and 61% of those with diagnosed diabetes had high blood sugar levels indicating that the condition was not well managed.
The incidence rate of end stage kidney disease for Indigenous Australians was seven times the rate for non-Indigenous Australians in 2012–14.
Risk factors
In 2014–15, 42% of Indigenous Australians aged 15 years and over reported being a current smoker, 2.7 times the non-Indigenous rate. Indigenous smoking rates in very remote areas have not improved (remaining at around 53%).
In 2012–13, 66% of Indigenous Australians aged 15 years and over were overweight or obese.
In the 2012–13 Health Survey, 20% of Indigenous adults had high blood pressure and most (79%) had not previously been diagnosed with the condition.
Child and maternal health
In 2014 nationally, 10.5% of babies born to Indigenous mothers were low birthweight, twice the non-Indigenous rate (4.7%).
In 2014, 46% of Indigenous women smoked during pregnancy, 3.6 times the non-Indigenous rate.
Health system
In 2012–13, 21% of Indigenous Australians reported having problems accessing dentists, 14% doctors, 9% other health professionals and 6% hospitals.
The proportion of hospitalisations with a procedure recorded was lower for Indigenous Australians compared with non-Indigenous Australians. Indigenous Australians also had lower rates of elective surgery and longer waiting times.
Discharge from hospital against medical advice was seven times the non-Indigenous rate in the two years to June 2015.
Social determinants
There has been no progress on the employment target since 2008. Indigenous Australians are more likely to experience exposure to violence, child abuse and neglect, and contact with the criminal justice system than other Australians. In 2011, 28% of homeless Australians were Indigenous.