This publication is the fifth in the biennial series of reports on the health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples. By drawing on recent data available from a variety of sources, it aims to provide a comprehensive picture of the health and welfare of Australia's Indigenous population. It covers a range of topics regarded as important for improving the health of Aboriginal and Torres Strait Islander peoples.
The definition of health that underpins the publication is a holistic one put forward in the National Aboriginal Health Strategy Working Party report:
‘Not just the physical well-being of the individual but the social, emotional and cultural well-being of the whole community. This is a whole of life view and
it includes the cyclical concept of life-death-life’ (National Aboriginal Health Strategy Working Party 1989).
The report updates information presented in the 2003 report and also provides new information in a number of areas. Some of the enhancements for this report include:
The breadth and depth of data assembled for this report provide useful information against each of the three main tiers in the National Health Performance Framework auspiced by the Australian Health Minister’s Conference i.e. health status and outcomes; determinants of health; and health system performance.
- a new chapter which explores the links between health and education (Chapter 3);
- a new chapter, called Housing circumstances, that presents information on both housing and homelessness issues (Chapter 4); and
- a new chapter on disability and ageing, using information from the 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) (Chapter 5).
Information about the broader social context and specific issues (determinants) that impact on the health and welfare wellbeing of Indigenous Australians is presented in Chapters 2, 3, 4, and 8. Chapter 2 provides background information on the demographic, social and economic context in which Indigenous Australians live. Chapter 3 provides information on education status. Chapter 4 examines the housing circumstances of Indigenous Australians, while Chapter 8 looks at behavioural and environmental health risk factors.
Health status of and outcomes for Indigenous Australians are described in Chapters 5, 6, 7, and 9. Chapter 5 focuses on disability and ageing, primarily using data from the 2002 NATSISS. Chapter 6 provides information on the health status of Indigenous mothers and children; Chapter 7 provides an overview of the health status of Aboriginal and Torres Strait Islander peoples; while Chapter 9 describes the mortality experienced by Indigenous Australians, including a discussion of trends where these can be observed.
Chapters 10 (Health service - provision, access and use) and 11 (Community services) look at system performance issues, including access to and utilisation of these services by Indigenous Australians.
Chapter 12 provides a summary of the relevant, available information about the health and welfare of Torres Strait Islander peoples.
A report on Indigenous data developments and information governance arrangements will also be available from the ABS web site (www.abs.gov.au) and the AIHW web site (www.aihw.gov.au) later this year.
The data presented in this report were drawn from key national statistical collections including the latest information from both the Australian Bureau of Statistics (ABS) and the Australian Institute of Health and Welfare (AIHW). Important new information about Aboriginal and Torres Strait Islander health and welfare was collected through the ABS 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). The report also includes data from other ABS collections such as the 2001 Census of Population and Housing, the 2001 Community Housing and Infrastructure Needs Survey (CHINS) and the 2001 National Health Survey (NHS). AIHW surveys such as Bettering the Evaluation and Care of Health (BEACH), and the national administrative data collections such as the National Hospital Morbidity data collection, the National Mortality data collection, the National Perinatal data collection and the Service Activity Reporting by Aboriginal Community Controlled Health Organisations are all important data sources used in the production of this report. In addition, the report includes updated analytic results, such as the updated estimates of expenditure on health services for Indigenous people.
Population estimates are based on population counts from the five yearly Census of Population and Housing, adjusted for births, deaths and migration. However, estimating the size and composition of the Indigenous population is difficult for a range of reasons including the incomplete and differential Indigenous identification in births and deaths records across jurisdictions, which do not support the standard approach to population estimation.
Estimates and projections of the Aboriginal and Torres Strait Islander population are therefore termed experimental. Unless otherwise indicated, rates in this publication are calculated from the low series of experimental estimates and projections based on the 2001 Census (ABS 2004e).
Indigenous identification is also incomplete in many other administrative data collections used in this report. The ABS and the AIHW, in partnership with state and territory authorities and the Indigenous community, are making efforts to improve the quality and completeness of Indigenous identification in key administrative data collections.