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The context of Aboriginal and Torres Strait Islander health

The context of Aboriginal and Torres Strait Islander health

The historical context of Aboriginal and Torres Strait Islander health

Aboriginal people are the original people of Australia [1]. Their continuity, history and cultural traditions are unrivalled in the world [2]. Aboriginal people have occupied their traditional lands throughout mainland Australia for 50,000 to 120,000 years [2]. The Torres Strait Islander people, on the other hand, have occupied 270 or so islands in the Torres Straits which runs between Australia and Papua New Guinea for over 2,500 years [2]. However, in addition to living in other parts of Australia, they continue to live on 17 of the islands with two communities on the far northern Queensland coast.

Aboriginal people have survived many challenges including droughts and floods [3]. Scientific proof of extreme climate due to a period of arid climate change has been found in an ancient site known as Warratyi, in the Flinders Range, SA where Aboriginal settlement dating from 50,000 years ago demonstrated the resilience of people, who endured even when large animals became extinct due to the conditions [4].

There are distinctive ethnic and cultural differences within Aboriginal and Torres Strait Islander societies, each having their own language and traditions [5]. Aboriginal and Torres Strait Islander people are the original custodians of many identified places in Australia. They enjoyed a semi-nomadic lifestyle in family and community groups, moving across a defined area following seasonal changes [2]. According to their cultural beliefs, the physical environment of each local area was created by the actions of spiritual ancestors as they travelled across the landscape.

Despite their differences, Aboriginal and Torres Strait Islander people have had many shared experiences of colonisation that have led to negative impacts on their health. Multiple generations have had pervasive risks to their wellbeing: psychologically; socially; spiritually and culturally and because of their connection to land [6]. The historical determinants of health still influence the current disadvantages in health outcomes [7]. Since the arrival of non-Indigenous people in 17882, introduced illness has caused a great deal of harm to the health of Aboriginal people. Negative health outcomes have been associated with deep underlying causes such as racism and discrimination, forced removal of children, loss of identity, language, culture and land [8].

The Overcoming Indigenous disadvantage: key indicators 2016 report highlights major events that characterise the historical context [8]:

Despite many challenges, Aboriginal and Torres Strait Islander people have made significant advances towards taking control of their futures and their health outcomes. In 2010, Kenneth (Ken) Wyatt AM, became the first Aboriginal Member of the Australian House of Representatives followed by Nova Peris (2013) and Linda Burney, The Australian Labor Party's Shadow Minister for Human Services in 2016, while Patrick Dodson, and Malarndirri McCarthy were elected to the Senate in the same year [9]. In 2016, Kenneth (Ken) Wyatt AM became the first Aboriginal person to be elevated to a ministerial role as Minister for Aged Care and Indigenous Health [10].

Deficit thinking has been a barrier to improving Aboriginal and Torres Strait Islander health outcomes. Shifting towards a strengths based approach has offered an alternative, as it highlights the value of people as cooperating individuals: it focuses on productive measures and offers no time for blame or negativity in the pursuit of shared progress. The Overcoming Indigenous disadvantage: key indicators 2016 report, reiterates a strong level of support for the strengths based pathway [8]. The approach is best described through tangible examples, which can be found in a number of health topics in this overview.

The strengths based pathway has been navigated as a direct response to the National Aboriginal and Torres Strait Islander health plan 2013-2023 which defines the strengths based approach:

A strengths based approach views situations realistically and looks for opportunities to complement and support existing strengths and capacities as opposed to a deficit-based approach which focusses on the problem or concern [11].

Through self-determination and strong community leadership, there is now momentum for culturally determined ‘health protecting factors’ including connection to land, culture, spirituality and ancestry [6]. The strengths based approach continues to embrace and endorse strategies, programs and policies that embody these health protective factors. It is also very important for strengths based approaches to adopt a decolonising agenda; ‘why it is vital that we all employ a more open and decolonising gaze’ [12].

Indicators of Aboriginal and Torres Strait Islander social disadvantage

The key measures in these areas for Aboriginal and Torres Strait Islander people nationally include:

Education

The 2011 Australian Census [13] reported that:

An ABS school report [14] showed that in 2015:

A national report on schooling in Australia [15] showed that in 2016:

Employment

According to the 2011 Australian Census [13]:

Income

The median real equivalised3 gross weekly household income for Aboriginal and Torres Strait Islander households in 2011-13 was $465 compared with $869 for non-Indigenous households [16].

Healing: featured section

In 2017, it will be the 20th anniversary of the release of the Bringing Them Home report. To recognise this important milestone we are presenting this short feature on healing. The Bringing Them Home report highlighted the importance of Aboriginal and Torres Strait Islander ownership of the design, implementation and management of services to support members of the Stolen Generations, their families and their communities [17]. The HealthInfoNet in partnership with the Healing Foundation has developed a Healing Portal to support workers in this important area (www.healthinfonet.ecu.edu.au/related-issues/healing).

Aboriginal and Torres Strait Islander people suffer significant health concerns, socio-economic disadvantage and shortened life expectancy compared with non-Indigenous Australians [18]. Underpinning this is the historical trauma associated with the legacy of colonisation, persistent unresolved issues over such things as land rights, self-determination and identity, and poor economic development and outcomes. This trauma has resulted in a sense of powerlessness, loss, grief, disconnection and helplessness for Aboriginal and Torres Strait Islander people [18]. It is thought that healing from the impacts of the historical colonial legacy, using both cultural and contemporary understandings and processes, is necessary for individuals, families and communities, before many other contemporary Aboriginal and Torres Strait Islander health issues can be addressed [18].

Stolen Generations

Since European colonisation of Australia, Aboriginal and Torres Strait Islander children have been forcibly separated from their families: these children are collectively known as the Stolen Generations [18]. Removal of Stolen Generations members from their families, identities, lands, languages and cultures by past governments has a profound impact on Aboriginal and Torres Strait Islander individuals, families and communities, causing considerable grief, loss and trauma [19]. The Bringing Them Home report outlined government removal policies which extended from the early 1900s to the 1970s and included the deliberate stripping of cultural practices and traditional law so that these practices would no longer exist in future generations [18][20]. These policies have resulted in a significant impact on the health and wellbeing of Aboriginal and Torres Strait Islander people, difficulties for parenting the next generation and for re-establishing cultural links [18].

In 2008, there were an estimated 26,885 Aboriginal and Torres Strait Islander people who reported that they were removed from their natural family [21]. The 2014-2015 National Aboriginal and Torres Strait Islander social survey (NATSISS) reported that Aboriginal and Torres Strait Islander people with a mental health condition were more likely to have been removed, or had relatives removed, from their natural family (50%) than those with other long-term health conditions (42%) and those with no long-term health conditions (34%) [22].

Healing Work

Stolen Generations members deal with trauma in ways that mostly do not involve generic counselling models used by the mainstream population [19]. The Bringing Them Home report highlighted that ‘only Indigenous people themselves are able to comprehend the full extent of the effects of the removal policies’ and recommended that ‘services to redress these effects must be designed, provided and controlled by Indigenous people themselves’ [17]. Many Stolen Generations members find that coming together and sharing stories with other survivors in a community setting, helps them heal [19]. Themes in healing projects include self-determination and community governance; reconnection and community life; and restoration and community resilience [18].

The Healing Foundation recently evaluated 31 healing projects based on the aforementioned principles and involved more than 3,676 Stolen Generations members, it found that: 72% of participants said they were better able to care for their trauma and grief in healthy ways; 68% felt more confident in accessing community support; and 77% reported an increased sense of belonging and connection to their culture [19].

Aboriginal and Torres Strait Islander population

Based on information from the 2011 Australian Census, the ABS has estimated the Aboriginal and Torres Strait Islander population at 744,956 on 30 June 2016 [23] (Table 1). The Aboriginal and Torres Strait Islander population accounted for 3.1% of Australia’s total population of 24 million [23][24]. The estimation for the Aboriginal and Torres Strait Islander population in NSW is the highest (229,951 people), followed by Qld (213,160), WA (97,681), and the NT (74,543). The NT has the highest proportion of Aboriginal and Torres Strait Islander people among its population (30%) and Vic the lowest (0.9%).

Table 1. Estimated Aboriginal and Torres Strait Islander (Indigenous) population, by jurisdiction, Australia, 30 June 2016

Jurisdiction

Indigenous population (number)

Proportion of Australian Indigenous population (%)

Proportion of jurisdiction population (%)

NSW

229,951

31

3.0

Vic

53,663

7.2

0.9

Qld

213,160

29

4.3

WA

97,681

13

3.5

SA

41,515

5.6

2.4

Tas

27,052

3.6

5.2

ACT

7,103

1.0

1.8

NT

74,543

10

30

Australia

744,956

100

3.1

Note:

Australian population includes Jervis Bay Territory, the Cocos (Keeling) Islands, and Christmas Island

Source: Derived from ABS, 2014 [23], ABS, 2016 [24]

There was a 21% increase in the number of Aboriginal and Torres Strait Islander people counted4 in the 2011 Census compared with the 2006 Census [25]. The largest increases were in the ACT (34%), Vic (26%), NSW (25%) and Qld (22%) [26]. For all jurisdictions, the 55 years and over age-group showed the largest relative increase (i.e. the Indigenous population is ageing). There are a number of 'structural' reasons contributing to the growth of the Indigenous population [27]:

Three other factors are considered likely to have contributed to the increase in the Indigenous population in the 2011 Census [27]:

In 2016, around 35% of Aboriginal and Torres Strait Islander people (262,297 people) lived in major cities, 45% (333,238 people) lived in inner and outer regional areas and 20% (149,421 people) lived in remote and very remote areas [23].

In terms of specific geographical areas, more than one-half (53%) of all Aboriginal and Torres Strait Islander people counted in the 2011 Census lived in nine of the 57 Indigenous regions5 [28]. In 2016, the largest projected populations were in three regions in eastern Australia (Brisbane, NSW Central and the North Coast, and Sydney-Wollongong), which accounted for 29% of the total Aboriginal and Torres Strait Islander population [23].

According to the 2011 Census, around 90% of Indigenous people were Aboriginal, 6% were Torres Strait Islanders and 4% people identified as being of both Aboriginal and Torres Strait Islander descent [28]. Around 63% of Torres Strait Islander people6 lived in Qld; NSW was the only other state with a large number of Torres Strait Islander people.

The Aboriginal and Torres Strait Islander population is much younger overall than the non-Indigenous population (Figure 1) (Derived from [29]). According to estimates from the 2011 Census, at 30 June 2016 about 34% of Aboriginal and Torres Strait Islander people were aged less than 15 years, compared with 19% of non-Indigenous people. About 4.2% of Aboriginal and Torres Strait Islander people were aged 65 years or over, compared with 15% of non-Indigenous people.

Figure 1. Population pyramid of Aboriginal and Torres Strait Islander and non-Indigenous populations, 30 June 2016

Note: Excludes 90 years and older age-group

Source: Derived from ABS, 2014 [23], ABS, 2013

References

  1. Malaspinas A, Westaway MC, Muller Craig, Sousa VC, Lao O, Alves I, Bergström A, Athanasiadis G, Cheng JY, Crawford JE, Heupink TH, Macholdt E, Peischl S, Rasmussen S, Schiffels S, Subramanian S, Wright JL, Albrechtsen A, Barbieri C, Dupanloup I, Eriksson A, Margaryan A, Moltke I, Pugach I, Korneliussen TS, Levkivskyi IP, Moreno-Mayar JV, Ni S, Racimo F, Sikora M, Xue Y, Aghakhanian FA, Brucato N, Brunak S, Campos PF, Clark W, Ellingvåg S, Fourmile G, Gerbault P, Injie D, Koki G, Leavesley M, Logan B, Lynch A, Matisoo-Smith EA, McAllister PJ, Mentzer AJ, Metspalu M, Migliano AB, Murgha L, Phipps ME, Pomat W, Reynolds D, Ricaut F, Siba P, Thomas MG, Wales T, Wall CM, Oppenheimer SJ, Tyler-Smith C, Durbin R, Dortch J, Manica A, Schierup MH, Foley RA, Lahr MM, Bowern C, Wall JD, Mailund T, Stoneking M, Nielsen R, Sandhu MS, Excoffier L, Lambert DM, Willerslev E (2016) A genomic history of Aboriginal Australia. Nature; 538(7624): 207-214
  2. Dudgeon P, Wright M, Paradies Y, Garvey D, Walker I (2014) Aboriginal social, cultural and historical contexts. In: Dudgeon P, Milroy H, Walker R, eds. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd ed. Canberra: Department of The Prime Minister and Cabinet: 3-24
  3. Robertson F, Stasiuk G, Nannup N, Hopper SD (2016) Ngalak koora koora djinang (Looking back together): a Nyoongar and scientific collaborative history of ancient Nyoongar boodja. Australian Aboriginal Studies; 2016(1): 40-54
  4. Hamm G, Mitchell P, Arnold L, Prideaux GJ, Questiaux D, Spooner NA, Levchenko VA, Foley EC, Worthy TH, Stephenson B, Coulthard V, Coulthard C, Wilton S, Johnston D (2016) Cultural innovation and megafauna interaction in the early settlement of arid Australia. Nature; 539(7628): 280-283
  5. NSW Department of Health (2004) Communicating positively: a guide to appropriate Aboriginal terminology. Sydney: NSW Department of Health
  6. Zubrick SR, Shepherd CCJ, Dudgeon P, Gee G, Paradies Y, Scrine C, Walker R (2014) Social determinants of social and emotional wellbeing. In: Dudgeon P, Milroy H, Walker R, eds. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd edition ed. Canberra: Department of The Prime Minister and Cabinet: 93-112 (chapter 6)
  7. Gee G, Dudgeon P, Schultz C, Hart A, Kelly K (2014) Aboriginal and Torres Strait Islander social and emotional wellbeing. In: Dudgeon P, Milroy H, Walker R, eds. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd ed. Canberra: Department of The Prime Minister and Cabinet: 55-68
  8. Steering Committee for the Review of Government Service Provision (2016) Overcoming Indigenous disadvantage: key indicators 2016 report. Canberra: Productivity Commission
  9. Parliament of Australia (2016) Indigenous parliamentarians, federal and state: a quick guide. Retrieved 19 October 2016 from http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1617/Quick_Guides/IndigenousParliamentarians
  10. Australian Government Department of Health (2017) The Hon Ken Wyatt AM, MP. Retrieved 24 January 2017 from http://www.health.gov.au/internet/ministers/publishing.nsf/Content/Profile-KW-1
  11. Australian Department of Health and Ageing (2013) National Aboriginal and Torres Strait Islander Health Plan 2013-2023. Canberra: Australian Department of Health and Ageing
  12. Sherwood J (2013) Colonisation - it's bad for your health: the context of Aboriginal health. Contemporary Nurse; 46(1): 28-40
  13. Australian Bureau of Statistics (2012) Census of population and housing: characteristics of Aboriginal and Torres Strait Islander Australians, 2011. Canberra: Australian Bureau of Statistics
  14. Australian Bureau of Statistics (2016) Schools, Australia, 2015. Canberra: Australian Bureau of Statistics
  15. Australian Curriculum Assessment and Reporting Authority (2016) National Assessment Program - Literacy and Numeracy: achievement in reading, writing, language conventions and numeracy: national report for 2016. Sydney: Australian Curriculum Assessment and Reporting Authority
  16. Steering Committee for the Review of Government Service Provision (2014) Overcoming Indigenous disadvantage: key indicators 2014. Canberra: Productivity Commission
  17. Human Rights and Equal Opportunity Commission (1997) Bringing them home: report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. Sydney: Human Rights and Equal Opportunity Commission
  18. Milroy H, Dudgeon P, Walker R (2014) Community life and development programs – pathways to healing. In: Dudgeon P, Milroy H, Walker R, eds. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd edition ed. Canberra: Department of The Prime Minister and Cabinet: 419-435 (chapter 24)
  19. Healing Foundation (2016) Healing for our Stolen Generations: sharing our stories. Canberra: Healing Foundation
  20. Peeters L, Hamann S, Kelly K (2014) The Marumali program: healing for Stolen Generations. In: Dudgeon P, Milroy H, Walker R, eds. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd edition ed. Canberra: Department of The Prime Minister and Cabinet: 493-508 (chapter 29)
  21. Australian Bureau of Statistics (2010) The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples, Oct 2010: Social and emotional wellbeing [data cube]. Retrieved 29 October 2010 from http://www.abs.gov.au/AUSSTATS/subscriber.nsf/log?openagent&social%20and%20emotional%20wellbeing%20data%20cube.xls&4704.0&Data%20Cubes&F0C653AD3494AB79CA2577CA00138F43&0&Oct%202010&29.10.2010&Previous
  22. Australian Bureau of Statistics (2016) National Aboriginal and Torres Strait Islander Social Survey, 2014-15: Table 19. Selected wellbeing indicators, by long-term health conditions [data cube]. Retrieved 28 April 2016 from http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4714.02014-15?OpenDocument
  23. Australian Bureau of Statistics (2014) Estimates and projections, Aboriginal and Torres Strait Islander Australians, 2001 to 2026. Canberra: Australian Bureau of Statistics
  24. Australian Bureau of Statistics (2016) Australian demographic statistics, Jun 2016. Retrieved 15 December 2016 from http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3101.0Main+Features1Jun%202016?OpenDocument
  25. Biddle N (2012) CAEPR Indigenous population project 2011 census papers: population and age structure. Canberra: Centre for Aboriginal Economic Policy Research
  26. Yap M, Biddle N (2012) Indigenous fertility and family formation: CAEPR Indigenous population project: 2011 census papers. Canberra: Centre for Aboriginal Economic Policy Research
  27. Biddle N (2013) CAEPR Indigenous population project 2011 census papers: population projections. Canberra: Centre for Aboriginal Economic Policy Research
  28. Australian Bureau of Statistics (2012) Census of population and housing - counts of Aboriginal and Torres Strait Islander Australians, 2011. Canberra: Australian Bureau of Statistics
  29. Australian Bureau of Statistics (2013) Population projections, Australia, 2012 (base) to 2101. Canberra: Australian Bureau of Statistics

Footnotes

2. The first Australian colony was formally proclaimed in 1788.

3. Equivalised household income adjusts the actual incomes of households to make households of different sizes and compositions comparable.

4. There is a difference between the census 'counts' and 'estimates'. The 'estimates' adjust for a number of factors and are more accurate.

5. Indigenous regions are large geographical units loosely based on the former Aboriginal and Torres Strait Islander Commission boundaries. 

6. Includes people who identified as Torres Strait Islanders and those who identified as being of both Aboriginal and Torres Strait Islander descent.

 

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