Aboriginal and Torres Strait Islander peoples’ health

Aboriginal and Torres Strait Islander peoples are the First Peoples of Australia. They have lived on this continent and in the Torres Strait for more than 60,000 years.

There are many distinct Aboriginal and Torres Strait Islander Nations (Opens in new tab) across Australia.

Each Nation has their own:

• culture
• language
• beliefs
• practices

The Aboriginal and Torres Strait Islander peoples' concept of health is holistic. It goes beyond physical health and includes the wellbeing of the whole person, family and community. This includes:

• social wellbeing
• emotional wellbeing
• cultural wellbeing
• spiritual wellbeing
• connection to Country

As of 2021, approximately 1 in 25 Australians identifies as Aboriginal and Torres Strait Islander peoples. The number isn't exact because not everyone completes the Census or answers the question on Indigenous status.

Most Aboriginal and Torres Strait Islander peoples live in major cities and regional areas. Around 1 in 7 Aboriginal and Torres Strait Islander peoples live in remote areas.

The Aboriginal and Torres Strait Islander peoples' population is younger on average than non-Indigenous Australians. This is linked to higher birth rates and differences in how long people are living. It is also influenced by broader social and health differences.

Life expectancy is often used to measure the overall health of the Aboriginal and Torres Strait Islander peoples' population. While life expectancy has improved over time, there is still a wide gap in how long Indigenous people live compared to non-Indigenous populations.

Generally, Aboriginal and Torres Strait Islander peoples living in major cities live longer than those in remote areas.

There are differences in health outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Key areas where inequity exists include:

• cardiovascular disease, including heart disease
• diabetes
• lung and airway conditions, such as asthma and chronic obstructive pulmonary disease (COPD)
• cancers
• factors that impact social and emotional wellbeing like mental health, self-harm and substance use

The impact of colonisation

Colonisation continues to affect the physical, social, emotional and spiritual wellbeing of many Aboriginal and Torres Strait Islander peoples.

These impacts are ongoing and influence health outcomes across generations. These include:

• disconnection from culture, family, and Country
• violence
• introduced diseases
• poverty, food insecurity and resource insecurity
• intergenerational trauma
• marginalisation, racism and systemic discrimination

In 2008, the Australian government launched the National Indigenous Reform Agreement (NIRA). It aimed to reduce the inequalities faced by Aboriginal and Torres Strait Islander peoples.

In 2019, the new National Agreement on Closing the Gap was established. This was a partnership agreement, to ensure decision-making in partnership with Aboriginal and Torres Strait Islander community-controlled peak organisations. This was signed in 2020 by:

• the Coalition of Peaks
• all Australian governments
• the Australian Local Government Association

The Coalition of Peaks is made up of over 80 Aboriginal and Torres Strait Islander community-controlled organisations across Australia. This includes both peak and member organisations.

The National Agreement is based around 4 priority reforms. These reforms aim to change the way governments work to improve life outcomes for Aboriginal and Torres Strait Islander peoples. The 4 priority reforms are:

1. Create and improve partnerships to ensure Aboriginal and Torres Strait Islander peoples' involvement in decision-making at national, state and local levels.
2. Develop Aboriginal and Torres Strait Islander community-controlled organisations to deliver Closing the Gap programs.
3. Ensure all government organisations:
   • improve accountability
   • identify and eliminate racism
   • respond to the needs of Aboriginal and Torres Strait Islander peoples
4. Improve access to regional data to allow Aboriginal and Torres Strait Islander communities to make informed decisions about their futures.

Over time, there have been improvements in health outcomes for Aboriginal and Torres Strait Islander peoples, such as:

• a decrease in deaths from cardiovascular and kidney disease
• increase in health checks for Aboriginal and Torres Strait Islander peoples
• improved outcomes in hospitals

There have also been improvements in birth and pregnancy outcomes. These include:

• more people are attending antenatal care in their first trimester of pregnancy
• fewer people are smoking during their pregnancy
• fewer babies are born small for their age (Opens in new tab)
• better management of trachoma (a type of eye infection)

Better access to culturally appropriate healthcare leads to better health outcomes. There are still many barriers to healthcare access. While some areas of health have improved, others have not, and some have worsened.

The National Aboriginal Community Controlled Health Organisation (Opens in new tab) (NACCHO) is the peak body for Aboriginal and Torres Strait Islander peoples' health.

NACCHO represents 148 Aboriginal Community Controlled Health Organisations (ACCHOs) across Australia.

An ACCHO is a service run by local Aboriginal and Torres Strait Islander communities.

The first ACCHO, Redfern Aboriginal Medical Service, opened in 1971. There are now over 300 clinics across Australia. They deliver holistic, comprehensive, and culturally appropriate primary healthcare services.

NACCHO plays a role in:

• giving advice to the Australian Government on policy
• advocating for health solutions developed by the Aboriginal and Torres Strait Islander community
• improving health outcomes for Aboriginal and Torres Strait Islander peoples

More information is available on Aboriginal and Torres Strait Islander peoples' health.

You can visit the Australian Indigenous HealthInfoNet (Opens in new tab) website for information about Aboriginal and Torres Strait Islander peoples' health and culture (Opens in new tab).

On the NACCHO website, you can learn more about ACCHOs (services run by local Aboriginal and Torres Strait Islander communities (Opens in new tab)) or find an ACCHO near you (Opens in new tab).

Visit the Closing the Gap (Opens in new tab) website for more information about the National agreement.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.