In 2008, the Australian government made a formal commitment to address Indigenous disadvantage in Australia, known as 'Closing the Gap', but what's "the gap”?

The gap refers to the the vast health and life-expectation inequality between Indigenous and non-Indigenous Australians. This inequality includes:

shorter life expectancy

higher rates of infant mortality

poorer health

and lower levels of education and employment

The Closing the Gap strategy has resulted in some improvements, but national statistics indicate there's still a long way to go. In 2017, the government came under pressure to add a target to lower Indigenous imprisonment rates. Other areas where statistics show a concerning gap in the experience between Indigenous and non-Indigenous Australians are child removals and community and family violence.

Social and cultural determinants of health

Social and cultural determinants of heath refer to the fact that the way we live, work and play affects our health. This means racism and discrimination, lack of education or employment, and cultural disconnection impact on a person's health.[1]

Disadvantage may have both immediate social, economic and cultural determinants, and deeper underlying causes.

“The relatively high rates of violence in Aboriginal and Torres Strait Island communities are influenced by immediate factors such as alcohol and illicit drug use, mental health issues and childhood experience of violence. However, a number of researchers also suggest that deeper underlying causes include ‘intergenerational trauma’ resulting from the ongoing and cumulative effects of colonisation, loss of land, language and culture, the erosion of cultural and spiritual identity, forced removal of children, and racism and discrimination.”

Overcoming Indigenous Disadvantage: Key Indicators 2014

It's important to view contemporary disadvantage among Indigenous Australians in the context of colonisation and its ongoing impact.

Infant mortality and life expectancy

Between 2014-2016, Indigenous children aged 0-4 were more than twice as likely to die than non-Indigenous children. In the Northern Territory, Indigenous infant mortality was 4 times higher than the national rate.[2]

From birth, Indigenous Australians have a lower life expectancy than non-Indigenous Australians:

Non-Indigenous girls born in 2010-2012 in Australia can expect to live a decade longer than Indigenous girls born the same year (84.3 years and 73.7 years respectively).

The gap for men is even larger, with a 69.1 year life expectancy for Indigenous men and 79.9 years for non-Indigenous men. [3]

Indigenous women also experience approximately double the level of maternal mortality in 2016. [4]

Physical and mental health

There's a strong connection between low life expectancy for Indigenous Australians and poor health.

In 2016, Indigenous children experienced 1.7 times higher levels of malnutrition than non-Indigenous children. [5]

In 2014-15, hospitalisation rates for all chronic diseases (except cancer) were higher for Indigenous Australians than for non-Indigenous Australians (ranging from twice the rate for circulatory disease to 11 times the rate for kidney failure). [6]

Just under half (45%) of Indigenous people aged 15 years and over said they experienced disability in 2014–2015, compared to 18.5% of the whole Australian population in 2012. [7]

Other major concerns include mental health, suicide and self-harm.

In 2015, the Indigenous suicide rate was double that of the general population. [8] Indigenous suicide increased from 5% of total Australian suicide in 1991, to 50% in 2010, despite Indigenous people making up only 3% of the total Australian population. The most drastic increase occurred among young people 10-24 years old, where Indigenous youth suicide rose from 10% in 1991 to 80% in 2010. [9]

Indigenous suicide increased from 5% of total Australian suicide in 1991, to 50% in 2010, despite Indigenous people making up only 3% of the total Australian population. The most drastic increase occurred among young people 10-24 years old, where Indigenous youth suicide rose from 10% in 1991 to 80% in 2010. 33% of Indigenous adults reported high levels of psychological distress in 2014-15, and hospitalisations for self-harm increased by 56% between 2004-05 and 2014-15. [10]

Education and employment

About 62% of Indigenous students finished year 12 or equivalent in 2014-15, compared to 86% of non-Indigenous Australians. This is an improvement on previous years. [11]

The proportion of 20–64 year olds with or working towards post-school qualifications has also increased (from 26% in 2002 to 42% in 2014-15). [12]

The employment to population rate for Indigenous 15–64 year olds was around 48% in 2014-15, compared to 75% for non-Indigenous Australians.[13]

Family and community wellbeing

Median weekly income for Indigenous Australians was $542 in 2014-15 compared with $852 for non-Indigenous Australians. [14]

Around 20% of Indigenous Australians lived in overcrowded households in 2014-15. In very remote areas the overcrowding was almost 40%. [15]

Rates of family and community violence in 2014-15 were around 22% for Indigenous people. [16]

Indigenous children were almost 10 times more likely to be placed in out of home care than non-Indigenous children in 2015-16.[17]

Incarceration

In September 2017, Indigenous prisoners represented 27% of the total full-time adult prisoner population, whilst accounting for approximately 2% of the total Australian population aged 18 years and over.The adult imprisonment rate increased 77% between 2000 and 2015. [18]

The detention rate for Indigenous children aged 10-17 years was 26 times the rate for non-Indigenous youth in 2016. [19]

In 2008, almost half of Indigenous males (48%) and 21% of females aged 15 years or over had been formally charged by police over their life time.[20]

Moving forward together

The Closing the Gap strategy has made some improvements to Indigenous health since it was introduced in 2008. Sadly, all except one of the seven Close the Gap targets were behind target in 2016.

More needs to be done in order for Indigenous people to enjoy health and life-expectancy equality in Australia.