Report on Health and Cultural Diversity of First Australians: Analysis

This report provides a comprehensive overview of the health and cultural diversity of First Australians, focusing on the disparities in life expectancy and mortality rates compared to non-Indigenous Australians. It examines the 'Closing the Gap' initiative, evaluating its progress and highlighting the challenges in achieving its targets. The report discusses the importance of healthcare access, the impact of chronic conditions, and the role of cultural determinants of health. It analyzes various strategies implemented by the Australian government, including partnerships with Aboriginal Community Controlled Health organizations, support for people with disabilities, school nutrition programs, immunization efforts, and initiatives promoting healthy lifestyles. The report also suggests recommendations, such as reducing smoking rates, to further improve health outcomes for First Australians, emphasizing the need for continued efforts to address health inequalities.

R AD A A D C RA D V RS RS A S RA A SUNNING HE : HE LTH N ULTU L I E ITY OF FI T U T LI N 1
Health and cultural diversity of first Australians
Name:
Institution:
Tutor:
Date:

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N 2
Health and Cultural diversity of first Australians
INTRODUCTION
Access to healthcare is necessary to indigenous Australians. Provision of primary
healthcare as well as specialist services for indigenous Australians is playing a key role in
preventing as well as managing different chronic conditions. There are many long lasting gains
when indigenous Australians are at the center of decision making regarding their healthcare
choices (Bertilone & McEvoy, 2015). This therefore means that focus should be on both the
social and cultural determinants of health so as to bolster their health and well-being. Closing the
gap in life expectancy by 20131 target is therefore important as it will lead to better health
among the indigenous communities in Australia.
Between 2005 and 2007 as well as between 2010 and 2012,the life expectancy gap in
males reduced by 0.8 years in males and 0.1 years in females. However, the indigenous mortality
rates have dropped by 14% from 1998.This drop coupled with no improvement from 2006, the
target is not on track.
DISCUSSION
Importance of closing the gap to healthcare professions
Closing the gap in life expectancy target is important to health professions in Australia.
This is due to the fact that it reduces the prevalence of chronic conditions as well as mortality
rates which have been associated with increased stress among the healthcare professions.

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N 3
Evaluation of closing the gap target
There are different parameters that have been used to evaluate the closing the gap
program to establish if it is not on track. Majority of them have however indicated that it is not
on track. One of the most important tools that has been used to assess the progress of closing the
gap in life expectancy initiative is the life expectancy at birth. Life expectancy at birth can be
defined as the time a new born can live if the current mortality rates remain constant .This
figures are usually published after every five years. According to the latest statistics about the
life expectancies at birth published in 2013,69.1 years was the life expectancy of indigenous
boys born between 2010-2012.For the indigenous females born during the same period, the life
expectancies was 73.7 years (Parker, Bodkin-Andrews, Marsh, Jerrim, & Schoon, 2013). The life
expectancies of non-indigenous boys on the other hand was 79.7 years meaning there was a gap
of 10.6 years. Among the non-indigenous Australians, the life expectancy at birth was 83.2 years
and this means the gap between the females was 9.5 years. Below is a table illustrating the gap in
life expectancy at birth between indigenous and non-indigenous Australians.
From 2005-2007 however, the life expectancy among indigenous Australians increased
by 0.3 years per year for the boys while for the girls, the life expectancy at birth increased at a

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N 4
rate of 0.1 years per year. The trend was similar between 2010 and 2012.From the figures, it
means that overall reduction in the gap was 0.3 years for the males and then 0.1 years for the
females (Browne, 2017). However, during the launch of reducing the gap, it was projected that
there should be a reduction in the gap at a rate of between 0.6 and 0.8 years in each year for the
target to be met. This means that the target is not on track and there is still more to be done to
narrow down the gap.
Mortality rates is another important tool that has been used to evaluate if the target is on
track or not. Mortality rates is defined as the number of deaths within a particular group of
people over a unit time. In Australia, this figures are published on an annual basis and it is better
than the life expectancy at birth in evaluating the progress of closing the gap target. According to
the figures published lately, the mortality rates among indigenous Australians dropped
significantly by 14% between 1998 and 2016.There was also a drop by 9% in mortality rates
among the non-indigenous Australians as well within the same period. Since then, there has not
been any drop in the mortality rates (Browne, Hayes, & Gleeson, 2014). Studies have established
that the mortality rates or ever increasing and this indicates that the closing the gap target is not
on track. Below is a graph demonstrating the patterns in the mortality rates in Australia.

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N 5
Areas/strategies of focus
The Australian government has enhanced partnerships with the indigenous Australians by
supporting the Aboriginal Community Controlled Health through the Network Funding
Agreement (NFA) as well as the National Aboriginal Community Controlled Health
Organizations. Another important strategy used is supporting the indigenous Australians that
have disabilities. According to different statistics, the indigenous Australians are twice more
likely to develop disabilities than the non-indigenous Australians. In response to this, the
National Disability Insurance Agency was established. The objective of this agency is to work
with indigenous Australians in metropolitan, regional as well as remote communities to ensure
that they get access to the scheme (Gorman & Vemuri, 2012). As of 2017, more than 5500
indigenous Australians have already benefited from the scheme.
The school nutrition program in the Northern Territory is another strategy. The Northern
Territory of Australia is the most hit in terms of the mortality rates. The Australian government
has therefore invested more than $24 million for this project for three years (Davey, 2017). The
rationale for this initiative is to provide nutritious meals to the children so as to improve school

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N 6
attendance as well as engagement. So far, 72 sites within 63 communities are benefiting from the
program whereby more than 5400 children are provided with meals on a single day. Besides
improving the nutrition status, the project also provides employment opportunities to more than
230 indigenous Australians.
Immunization has also been used to reduce the gap in life expectancy. Organizations such
as the United Nations Children’s Fund and the World Health Organization have in the last
decade emphasized the importance of immunization. Immunization can be used to prevent death
from preventable diseases (Cashman et al., 2016). The Australian government has therefore
improved the coverage rates of immunization among the indigenous Australians. The National
Immunization Program which is a partnership between the government and different state and
territory governments was set up in 1997 to cut down on the vaccine preventable diseases. The
results have been phenomenal since the immunization rate among the 5 year cohorts has
improved significantly. This program immunize children against 17 vaccine preventable diseases
and it was increased further in 2017 to include catch up vaccines to young adults as well.
Encouraging healthy lifestyle choices has also been a focus to reduce the gap in life
expectancy. The Australian government has invested more than $135 million to support more
than 150 activities through sports so as to achieve closing the gap target. The aim of this program
is to increase participation of the indigenous communities in activities that prevents diseases
such as diabetes. The Outback stores was also set up in 2006 due to the difficulties experienced
by the indigenous Australians in accessing quality and affordable food. This program was
therefore set up to ensure that the Aboriginal and Torres Strait Islander people in Australia get
access to quality and affordable food. So far, there are more than 36 stores in the Northern
Territory, Western Australia and South Australia just to ensure that quality and affordable food is

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N 7
available in those regions (Clifford, Doran, & Tsey, 2013). As at 2017, the outback stores
program has seen a reduction in sugary drinks and increased consumption of fresh fruits and
vegetables. This has generally improved their health and reduced the gap in life expectancy.
Suggestion/recommendation
Besides the numerous efforts by the Australian Government to close the gap in life
expectancy, there is still more that should be done. According to statistics, smoking is one of the
factors that lead to deterioration of health among many indigenous Australians. The trends in
smoking among the Aboriginal and Torres Strait Islander people is on the high as illustrated by
the diagram below.
This therefore means that the Australian Government should work hard to reduce the rate
of smoking among the indigenous Australians. There should be efforts to ensure that pregnant
indigenous women do not smoke as well as reduce their exposure to tobacco together with their
families. Several studies link exposure to tobacco and increased mortality and morbidity in
children. The government should seek ways to combine population level strategies and
approaches to control tobacco .Such measures can include increasing the cost of tobacco

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N 8
products as well as setting up different legislative policies on smoking (Cumming, Kinner, &
Preen, 2016).. This efforts coupled with the programs already in action, will see a considerable
improvement towards closing the gap in life expectancy between indigenous and the non-
indigenous Australians.
Conclusion
There is a wide gap in life expectancy between indigenous and the non-indigenous
Australians. The gap is around 10 years for the males while for the females, it is 9 years. The
wide gap in life expectancy means that the mortality rates among the Aboriginal and Torres
Strait Islander people in Australia is very high .It is for this reason that closing the gap in life
expectancy by 2031 initiative was established. The objective of this program was to reduce the
wide gap in mortality rates. There have been different strategies that have been employed to
achieve this target. Some of the strategies used include immunization, modification of the
lifestyles among indigenous Australians, nutrition projects in school at the Northern Territory,
supporting people with disabilities and partnerships between the Australian government and the
indigenous Australians. Despite all this efforts, the target is not on track and this is indicated by
the increasing mortality rates since 2006.More efforts ought to be employed by the government
to achieve this target. Such additional efforts include reducing smoking among the indigenous
Australians.

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N 9
References
Bertilone, C., & McEvoy, S. (2015). Success in Closing the Gap: favourable neonatal
outcomes in a metropolitan Aboriginal Maternity Group Practice Program. The
Medical Journal of Australia, 203(6), 262. doi:10.5694/mja14.01754
Browne, A. J. (2017). Moving beyond description: Closing the health equity gap by
redressing racism impacting Indigenous populations. Social Science & Medicine, 184,
23-26. doi:10.1016/j.socscimed.2017.04.045
Browne, J., Hayes, R., & Gleeson, D. (2014). Aboriginal health policy: is nutrition the ‘gap’
in ‘Closing the Gap’? Australian and New Zealand Journal of Public Health, 38(4),
362-369. doi:10.1111/1753-6405.12223
Cashman, P. M., Allan, N. A., Clark, K. K., Butler, M. T., Massey, P. D., & Durrheim, D. N.
(2016). Closing the gap in Australian Aboriginal infant immunisation rates -- the
development and review of a pre-call strategy. BMC Public Health, 16(1).
doi:10.1186/s12889-016-3086-x
Clifford, A. C., Doran, C. M., & Tsey, K. (2013). A systematic review of suicide prevention
interventions targeting indigenous peoples in Australia, United States, Canada and
New Zealand. BMC Public Health, 13(1). doi:10.1186/1471-2458-13-463
Cumming, C., Kinner, S. A., & Preen, D. B. (2016). Closing the Gap in Indigenous health:
why section 19(2) of the Health Insurance Act matters. The Medical Journal of
Australia, 205(6), 283. doi:10.5694/mja16.00593
Davey, R. X. (2017). The economic benefits of eliminating Indigenous health inequality in
the Northern Territory. The Medical Journal of Australia, 206(4), 186.
doi:10.5694/mja16.01140

A A D C RA D V RS RS A S RA A SHE LTH N ULTU L I E ITY OF FI T U T LI N
10
Gorman, J., & Vemuri, S. (2012). Social implications of bridging the gap through ?caring for
country? in remote Indigenous communities of the Northern Territory, Australia. The
Rangeland Journal, 34(1), 63. doi:10.1071/rj11037
Parker, P. D., Bodkin-Andrews, G., Marsh, H. W., Jerrim, J., & Schoon, I. (2013). Will
closing the achievement gap solve the problem? An analysis of primary and
secondary effects for indigenous university entry. Journal of Sociology, 51(4), 1085-
1102. doi:10.1177/1440783313498946