Closing the Gap on Aboriginal and Torres

Strait Islander disadvantage

Close the Gap day seminarUniversity of Melbourne21st March, 2013

A/Professor Jane Freemantle

Overview• Consider the pieces of the puzzle

• History• Demographics• Some statistics

• Getting it right

• Put the pieces of the puzzle together• Stolen generation• Loss of lifestyle and culture• Poor living environment

• The issues are known, the solutions are achievable

In the beginning:……

• It is estimated that prior to the arrival of British settlers, the population of Indigenous Australians was approximately 318,000–750,000 across the continent.

• By 1900 the recorded Indigenous population of Australia had declined to approximately 93,000

• 30th June 2006, 517,200 people identified as Aboriginal and Torres Strait Islanders,

1301.0 – Year Book Australia, 2002 Australian Bureau of Statistics 25 January 2002

Previous population counts

• 30th June 2011, 548,370 people identified as Aboriginal and Torres Strait Islanders, of these:• 90% identified as Aboriginal only• 6% as Torres Strait Islander• 4% as both Aboriginal and Torres Strait

Islander• Number represents ~ 2.5% of the Australian

population (An increase of 20.5 per cent more Australians identified as Aboriginal and Torres Strait Islander than in the 2006 Census)

• Definition: “An Aboriginal or Torres Strait Islander is a person of Aboriginal or Torres Strait Islander descent who identifies as an Aboriginal or Torres Strait Islander and is accepted as such by the community in which he or she lives” (1983 the High Court of Australia)

Current population

• Currently, there are no data of sufficient quality to determine the number of Aboriginal and Torres Strait Islander births or deaths in Victoria Australia:

• There is a significant under ascertainment of Aboriginal and Torres Straits Islander births as information describing mothers’ Indigenous status only is collected at the time of the birth, fathers’ Indigenous status is NOT included

• Accurate and complete ascertainment of all births is necessary to provide:– Reliable information to inform policy and program development,

to evaluate policies aimed at improving service delivery and health status and to assess the effectiveness of programs and interventions.

– A denominator from which to calculate accurate mortality rates for infants, children and young people.

Getting it right!

Inconsistent and inaccurate recording of ‘Indigenous status’

Aboriginal births by dataset

‘99 ’00 ‘01 '02 ‘03/04

‘’04/05

‘05/06

‘06/07

AHLOTotal Aboriginal births

353 303 363 299 310 397 449 550

VPDCBirths to Aboriginal mothers

452 377 421 416 362 435 538 569

RBDMTotal Aboriginal births

521 452 522 601 722 719 802 782

VAEDBirths to Aboriginal mothers

363 333 379 411 n/a 433 502 589

Victorian Aboriginal Child Mortality Study, 1988-2008

Population distribution

Aboriginal and Torres Strait Islander Australia

Births by mother’s residential remoteness area, 2008

0%10%20%30%40%50%60%70%80%90%

100%

Aboriginal Non-Aboriginal

Very remoteRemoteOuter regionalInner regionalMajor cities

Population profile by Indigenous status, age and sex, 2011

Loss of Lifestyle &

Culture

Where to from Here?

Poor Living Environment

Stolen Generation

PIECING THE PUZZLE OF PLIGHT TOGETHER

The Stolen Generations• Official government policy 1909 - 1969 (=60yrs!)• Aboriginal children who were ‘not of full blood’ were

raised as ‘white’ and taught to reject their Aboriginality• Poor education was provided; Aboriginal children

employed as labourers or servants• Many parents never saw their children again & siblings were

deliberately separated

This is not ancient history!Today there are Aboriginal adults as young as their late 40’s and50’s who are members of the Stolen Generations

Proportion of Year 3 students who achieve the numeracy benchmark

0.0

10.0

20.0

30.0

40.0

50.0

60.070.0

80.0

90.0

100.0

2001 2002 2003 2004 2005

Perc

ent

All Students

Indigenous students

Proportion of Year 7 students who achieve the numeracy benchmark

0102030405060708090

2001 2002 2003 2004 2005

Perc

ent

All StudentsIndigenous students

Education

Stolen Generation

Around Indigenous 10,000 students enrolled across Australia (0.7% ~2.9% total pop)

Tertiary graduates 9 Aboriginal dentists, a handful of pharmacists, 153 medical practitioners, and 218

medical students – !1ENT specialist DR Kelvin Kong (2008) no surgeons or physicians –

16 practising lawyers and 2 Indigenous magistrates no judges.

30 qualified engineers

PIECING THE PUZZLE OF PLIGHT TOGETHER

Loss of Lifestyle & Culture

Loss of Lifestyle &

Culture

Low birthweight babies per 100 livebirths, by Aboriginal status of the mother and state/territory,

2003-2005 combined

NSW Vic Qld WA SA ACT NT Aus total0

2

4

6

8

10

12

14

16

18

20

Aboriginal Non-Aboriginal

Rate

per

100

live

birt

hs

Source: AIHW, Aboriginal & Torres Strait Islander Health Performance Framework 2008 Report

Loss of Lifestyle &

Culture

Infant mortality rates by Aboriginal status, NSW, Qld, SA, WA & NT combined

2004-06 2005-07 2006-08 2007-090

2

4

6

8

10

12

Aboriginal Non-Aboriginal

Rate

/1,0

00 li

ve b

irths

Source: ABS, Deaths Australia 2009

Loss of Lifestyle &

Culture

1980-1984 1985-1989 1990-1994 1995-1997 1998-2001 2002-20040.0

2.0

4.0

6.0

8.0

10.0

12.0

Aboriginal Non-Aboriginal

Birth year group & relative risk

Rat

e/10

00 li

ve b

irths

Mortality attributed to SIDS, WA born infants, 1980-2004

RR 5.60 RR 2.74 RR 8.22 RR 7.74 RR 8.22 RR 7.20

0 20 40 60 80

1-<4yrs

>4-<14 yrs

Age

gro

ups

at d

eath

Rate per 100,000 infant survivors

non-IndigenousIndigenous

RR =2.3

RR=2.9

Source: SCRGSP 2007

Age-specific death rate, and relative risk (RR) for Indigenous compared with non-Indigenous children, 2001-2005

Rates of children <4 years hospitalised for injuries, 2004-2005

Indigenous non-Indigenous0

50100150200250300

Rat

e pe

r 100

0

Children Aged <4 yearsSource: SCRGSP 2007

PIECING THE PUZZLE OF PLIGHT TOGETHER

Poor Living Environment

Poor Living Environment

Aboriginal people are 20 times more likely to be homeless. (Australian Government Footprints in time - The longitudinal study of Indigenous children)

Overcrowding

In 2008:• 92,700 or 31% of Aboriginal and Torres Strait

Islander children and youth lived in overcrowded housing

• In remote areas, more than half (58%) of all children and youth lived in overcrowded housing.

NOTE: ‘children' refers to people aged 0–14 years. The terms 'youth' and 'young people' refer to people aged 15–24 years.

Data presented are from the ABS National Aboriginal and Torres Strait Islander Social Survey, 2008 (cat. no. 4714.0).

Poor Living Environment

Infectious DiseasesAboriginal and Torres Strait Islanders experience:• a greater burden of communicable and non-

communicable infectious diseases• the highest rates of bacterial respiratory diseases

reported in the literature• an incident rate of meningococcal infection of

approximately six times that of the non- Indigenous population (WA)

• a high prevalence of gastroenteritis; major cause of hospitalisation of infants (WA)

• a significantly higher rate of invasive pneumococcal disease compared with non-Indigenous Australians

Poor Living Environment

Poor Living Environment

• Ear disease can reduce a child’s ability to understand what’s being taught in school

• Poor education leads to poor employment and lower income

• = Long-term cycle of disadvantage

Hypothesized risk pathways associated with Otitis Media & Juvenile Justice

Poor maternal diet,infections, alcohol, drug use & smoking

Genetic factors

Poor housing, overcrowding & smoking

Low Birth Weight

Deafness

School & learning difficulties Peer

problems

Difficulties within the family

Negative thinking patterns

Low self-esteem

Alcohol & Drugs

Increasingpsychosocial difficulties

Acute Stress Significant Loss

Depression

Suicidal behaviour

Time

Poor diet & nutrition

Otitis media

Pregnancy Birth Infancy Childhood Adolescence

Early contact with Juvenile Justice

Ref. Silburn & Freemantle

Poor Living Environment

Poor Living Environment

Stolen Generation

Loss of Lifestyle &

Culture

Where to from Here?

Piecing the Puzzle of Plight together

Where to from Here?

Understand…To work effectively with Aboriginal young people, their

families and their communities, understand: • The impact of non-Aboriginal people on the lives of

Aboriginal people • The continuing disadvantage facing Aboriginal young

people • A holistic view of health and wellbeing • The importance of self determination and working in

partnership with Aboriginal communities• How to make your service culturally appropriate for

Aboriginal people.

Where to from Here?

A poster by Chelsea Westlake of Cosmo Newberry

Where to from Here?

Where to from Here?

Education Attainment

UnemploymentPoverty

Alcohol Abuse

Birth Weight

Infant MortalityLifestyle Disease

Housing Environment

RHDEar Disease

Resp. DiseaseOvercrowding

Cultural CompetenceEfficient/Effective Service Provision

Indigenous Service Providers

‘CLOSE THE GAP’ IN INDIGENOUS

DISADVANTAGE