Australia: New report of Aboriginal health lagging nearly a century behind non-Indigenous peers Print E-mail
Sydney ~~ 30 April 2007

MEDIA, NEWS & EVENTS

Indigenous health: 100 years behind

Indigenous peoples’ health is 100 years behind that of other Australians, according to work carried out by UNSW researchers.
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Dr Lisa Jackson Pulver and two of her colleagues from the School of Public Health and Community Medicine (SPHCM) have authored the work on Indigenous health in Australia and New Zealand for the Commission on the Social Determinants of Indigenous Health. The Commission will be using this and other information to feed into a bigger report to the World Health Organisation (WHO) over the next year or so.

The Commission on the Social Determinants of Indigenous Health met in Adelaide to discuss the findings.

“Indigenous people are affected by health problems which have not affected the rest of the Australian population for a long time,” said Dr Jackson Pulver, from the Muru Marri Indigenous Health Unit at UNSW.

"Infections like boils and diseases like leprosy, rheumatic heart disease and tuberculosis haven't been experienced in white populations for decades, but they are still problems for some Indigenous communities," she said.

“On many indicators, our health now remains unacceptably lower and at levels experienced nearly a century ago by our non-Indigenous peers,” the report states.

Poor health indicators for Indigenous Australians include shorter average life expectancies (59.4 years for Aboriginal men compared to 76.6 for all males and 64.8 years for Aboriginal women compared to 82 for all women), greater levels of ill health resulting in higher levels of disability and reduced quality of life and high rates of established behavioural health risk factors such as smoking and substance abuse.

The report suggests that Indigenous peoples’ conception of health is holistic and linked to community well-being as well as individual health status.

“The influence that structural determinants have on inequities cannot be addressed without fundamental changes to the consequences of a history of colonisation,” the report concludes. “Restoring access to cultural and social facilities that maintain social capital for the Indigenous peoples of Australia and New Zealand will do much to maintain resilience that is a defining character of all Indigenous people.

“Prime Minister Howard refers to the recognition of past wrongs as the black-arm band view of history for which he is unwilling to say sorry…However, to see the acknowledgement of past wrongs as symbolic fails to acknowledge the profound psychological impacts that these past and current wrongs have on Aboriginal peoples’ sense of identity and our capacity to actively participate in Australian society,” the report reads.

Dr Jackson Pulver is the first author on the chapter, the co-authors are UNSW’s Liz Harris and John Waldon, from Massey University in NZ, who is a conjoint of UNSW.

Contact details: Dr Lisa Jackson Pulver, 0404 859 989, Susi Hamilton, UNSW Media unit, 9385 1583 or 0422 934 024

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 Monday April 30 2007
This is a transcript from PM. The program is broadcast around Australia at 5:10pm on Radio National and 6:10pm on ABC Local Radio.

Aboriginal health 100 years behind: report

Reporter: Jennifer Macey

MARK COLVIN: In the first decade of the 21st Century the scourges of leprosy, rheumatic heart disease and tuberculosis still strike many Aborigines and Torres Strait Islanders. Years after medicine and preventive care largely wiped them out in white populations in Australia.

A report to the World Health Organisation has found that Aboriginal health lags a full century behind that of other Australians.

The report by researchers at the University of New South Wales suggests that symbolism is important, even in health care.

It says acknowledging past wrongs done to Aboriginal people would help improve their health.

Jennifer Macey reports.

JENNIFER MACEY: It's hard to believe Australia's Indigenous communities still suffer from leprosy and tuberculosis - diseases most often associated with the developing world.

The difference doctors say, is that in the developing world, modern medicine and drugs such as penicillin are simply not available.

Dr Lisa Jackson Pulver from the University of News South Wales Muru Marri Indigenous Health Unit.

LISA JACKSON PULVER: For example, Indigenous babies born today can expect to live only as long as people in Australia 100 years ago. The Aboriginal people are dying at the same kinds of rates that people did 100 years ago in Australia.

Now remember, this is the days before penicillin, you know, 100 years ago was the days before broader public health interventions were available, and this is occurring today.

JENNIFER MACEY: Dr Jackson Pulver has written a chapter on Australia's Indigenous population for the World Health Organisation's Commission on Social Determinants of Health.

She says social factors such as colonisation and the stolen generations have had an impact on the living standards and health for Aboriginal people.

LISA JACKSON PULVER: Things like people not having access to education and to health services, people being alienated from their country, land, language and culture, the effects of colonisation are persistent and ongoing.

And all of these things combine together to create a picture of ill health in Australian Aboriginal and Torres Strait Islander people.

JENNIFER MACEY: These findings are similar to a report released last month by Oxfam and the National Aboriginal Community Controlled Health Organisation or NACCHO. It found that Australia ranks last for health in a table of wealthy countries with Indigenous populations.

NACCHO's Chief Executive Officer Dea Delaney Thiele says a one per cent increase in the health budget would put Indigenous health spending on par with the rest of Australia.

DEA DELANEY THIELE: If you were to look at the reports that have been commissioned by governments, if you look at Access Economics, that's a figure of about $450 million and that's just to bring it up onto par with what other Australians get. That doesn't actually take into consideration the burden of ill health.

JENNIFER MACEY: The Federal Health Minister Tony Abbott acknowledges the gap between the life expectancy for Aboriginal people compared to other Australians. But he says it's a long-term problem that requires long-term solutions.

TONY ABBOTT: This Government has a much better record than any of its predecessors and I think you'll find us building on that record. But I don't think you can realistically expect an immediate cash injection of the dimension that you suggest, for the simple reason that you've got to have the infrastructure in place to make the spending effective.

JENNIFER MACEY: Mr Abbott doesn't believe simply saying sorry will do much to improve people's health.

TONY ABBOTT: It's all very well to talk about formal apologies and so on, but I think Indigenous people and indeed the general population are much more interested in seeing better practical outcomes than they are in gestures.

JENNIFER MACEY: However, the CEO of NACCOH Dea Delaney Thiele says improving Indigenous health is not just a matter of matter of buying more medical equipment. She says it requires a holistic approach, including preventative health care, adequate housing and promoting healthy lifestyles.

DEA DELANEY THIELE: Our services are underpinned by our definition of health, which is health to Aboriginal people is not just the physical wellbeing of the individual, it's the social, emotional, cultural and spiritual well-being of the whole community.

MARK COLVIN: Dea Delaney Thiele, the CEO of the National Aboriginal Community Controlled Health Organisation, ending Jennifer Macey's report.

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 London ~~ Tuesday May 2 2007

Aboriginal health 'a hundred years behind whites'

By Kathy Marks in Sydney

Health standards among Australia's Aborigines are as poor as those among the white population before the advent of penicillin nearly a century ago, according to the World Health Organisation (WHO).

A WHO report found that Aborigines still suffered from leprosy, tuberculosis and rheumatic heart disease, all of which were eradicated decades ago in other developed nations. In some parts of New South Wales the average life expectancy for Aboriginal men was 33.

The paper was presented to a meeting in Adelaide of the WHO's Commission on the Social Determinants of Indigenous Health, which is also investigating the situation in New Zealand, the US and Canada. It concluded that, on every indicator, the state of health of Australian Aborigines was far worse than that of indigenous populations in other developed nations.

Lisa Jackson Pulver, who co-authored the chapter on Australia and New Zealand, criticised the Australian government for failing to address the root causes of poor health. They included a long-standing refusal to recognise the injustices of the past, she said.

Dr Jackson Pulver, from the Indigenous Health Unit of the University of New South Wales, wrote: "It is acknowledged by the government that Aboriginal Australians have poorer health, educational, employment and social outcomes, however the solutions to address these issues have little to do with the underlying causes." These were "a combination of material deprivation and psycho-social stressors related to stress, alienation, discrimination and lack of control".

In New Zealand there were still health inequalities between the Maori and white populations, but the gaps were fewer and smaller than in Australia, and closing. "Unfortunately we can't say the same [in Australia]," Dr Jackson Pulver said. "On many indicators, [indigenous] health now remains unacceptably lower and at levels experienced nearly a century ago by our non-indigenous peers."

She told ABC Radio: "Indigenous babies born today can expect to live only as long as people in Australia 100 years ago. The Aboriginal people are dying at the same kind of rates that people did 100 years ago in Australia... before penicillin."

Researchers found life expectancy among white Australians was 76.6 for men and 82 for women. In Aboriginal communities it was 59.4 for men and 64.8 for women.

Dr Jackson Pulver believes the after-effects of colonisation and injustices such as the forcible removal of Aboriginal children from their families were still having an impact. The factors included "people being alienated from their country, land, language and culture", she added.

She noted in the report that the Australian Prime Minister, John Howard, referred to the "recognition of past wrongs as the black armband view of history", and was unwilling to make a formal apology.

A report last month by Oxfam and the National Aboriginal Community Controlled Health Organisation (NACCHO) reported similar findings. Dea Delaney Thiele, chief executive of NACCHO, told ABC that a 1 per cent increase in the national health budget would place indigenous health spending on a par with the rest of Australia.

The Health Minister, Tony Abbott, said the gap was "something which no one can be happy about". But, he added: "I don't think you can realistically expect an immediate cash injection of the dimension you suggest, for the simple reason that you've got to have the infrastructure in place to make it effective."
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May 3 2007

Aborigine health '100 years behind'


Aborigines and Torres Strait islanders make up just over 2 per cent of Australians [Reuters]

Standards of healthcare for Australia's indigenous community lag more than 100 years behind the rest of the country, a report for the World Health Organisation has found.
 
In some parts of the country the life expectancy for Aborigine males is just 33 years – the same for men born in Rwanda or Ethiopia.

At the same time, Aboriginal people are still suffering from diseases unheard of in much of the developed world, such as leprosy, tuberculosis and rheumatic heart disease, the report said.
Nationwide the life expectancy for Aborigines and Torres Strait islanders, who make up just over 2 per cent of the population, is at least 17 years below Australians in general.
 
The study comes as much of the rest of Australia is enjoying unprecedented prosperity on the back of an economic boom fuelled by China and India's demand for the country's natural resources.
 

Health gap

Life expectancy

Australian males: 77 years
Aboriginal males: 59 years

Australian females: 82 years
Aboriginal females: 65 years

Source: Muru Marri indigenous health unit, University of New South Wales

"On many levels, indigenous health remains unacceptably low and at levels experienced nearly a century ago by our non-indigenous peers," said Dr Lisa Jackson Pulver, of the University of News South Wales indigenous health unit, one of the authors of the study.
 
In April a similar survey, conducted by Oxfam and Aboriginal community health organisations, ranked Australia last in a table of wealthy countries over the health of their indigenous populations.
 
Al Jazeera's correspondent Dan Nolan, who is in the central Australian town of Alice Springs, says the report confirms what has long been clear in towns such as Alice Springs: that Aboriginal people in Australia are among the most disadvantaged indigenous people in the developed world.
 
Guilt

Aboriginal children face much shorter lives than other Australians, the study said [GALLO/GETTY]

John Howard, the Australian prime minister, has said the country should not have a "black armband" view of history, saying the country should look forward and not be weighed down by guilt over wrongs committed over the past 200 years.
 
But the authors of the WHO report disagree, saying much of the blame for the state of Aboriginal health can be traced back to the effects of colonisation and the forced removal of Aboriginal children from their families.
 
The report speaks of Aboriginal people being alienated from their country, their land, language and culture and suggests that despite what the government says, an acknowledgement of that is key to solving the problem.
 
Progress will not be made until the government publicly acknowledges the role of "stress, alienation, discrimination and lack of control" in creating poor health in the Aboriginal community, the authors wrote.
 
"To see the acknowledgement of past wrongs as symbolic fails to acknowledge the profound psychological impacts that these past and current wrongs have on Aboriginal peoples' sense of identity and our capacity to actively participate in Australian society," they said.
 
Preventable

The report says Aboriginal alienation is at the core of the problem [EPA]

The report suggests that a small increase in health spending, just 1 per cent of the government's healthcare budget, would bring the level of spending on Aboriginal health up to that of the rest of population.
 
According to the WHO, Aboriginal people are more likely to smoke, abuse substances, exercise infrequently and be obese, resulting in high rates of non-communicable diseases which are, to a great extent, preventable.
 
Commenting on the report, Tony Abbott, the Australian health minister, acknowledged the gap between the life expectancy of Aborigines and other Australians but said practical solutions rather that "gestures" were needed.
 
"It's all very well to talk about formal apologies but I think indigenous people and the general population are much more interested in seeing better practical outcomes than in gestures, however meaningful those gestures might be to some," he said.

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