Aboriginal and Torres Strait Islander (First Nations) peoples in Queensland receive health care via government, non-government providers and the ATSICCHS Sector. This includes healthcare providers such as GPs, nurses, allied health providers (such as dietitians, podiatrists and physiotherapists), midwives, pharmacists, dentists, and Aboriginal and Torres Strait Islander Health Workers and Practitioners working in primary and tertiary care [31982]. The First Nations health workforce make a vital contribution to health care in Australia by enhancing the range and quality of clinical services provided to First Nations clients and providing communities with comprehensive, holistic health care and culturally appropriate engagement with First Nations peoples [2661].

Cultural safety and self-determination within health care is supported across Queensland’s ATSICCHS by Queensland Aboriginal and Islander Health Council (QAIHC), the state’s peak body. QAIHC’s member ATSICCHS are dedicated to improving First Nations health outcomes in Queensland by delivering comprehensive and culturally appropriate primary health care. QAIHC’s ten-year blueprint (2024-2034), Strong sector, strong system, sets the strategy for growing the ATSICCHS sector and its impact so that First Nations peoples, families and communities throughout Queensland are engaged, self-determining and strong [49786].

Queensland Health is comprised of the Department of Health, which is responsible for the overall management of the public health system in Queensland, and a network of 16 Hospital and Health Services (HHSs) which are responsible for the delivery of public health services. All HHSs have co-developed First Nations health equity strategies that commit to advancing health equity within their services for First Nations peoples in Queensland. These strategies are supported by the HealthQ32: First Nations first strategy 2032, and aligns with Queensland Health’s HEALTHQ32: a vision for Queensland’s health system that commits to eliminating racism within the health system and providing First Nations peoples with access to culturally safe and coordinated healthcare services [50444].

The First Nations Health Office within Queensland Health, led by the Chief First Nations Health Officer, works across the health system to improve health equity and outcomes for First Nations peoples. Making tracks toward closing the gap in health outcomes for Indigenous Queenslanders by 2033 provides the overarching framework to guide these efforts [19393].

According to the 2021 Census, Aboriginal and Torres Strait Islander (First Nations) peoples make up 4.6% of the Queensland population [51061]. Of those who identify as Aboriginal and/or Torres Strait Islander in Queensland, 81.5% identify as Aboriginal, 9.2% as Torres Strait Islander, and 9.3% as both Aboriginal and Torres Strait Islander [51054]. Almost two thirds (64.5%) of Australia’s Torres Strait Islander population reside in Queensland [51051]. Along with the Australian Capital Territory, Queensland also has the highest projected growth rate for Aboriginal and/or Torres Strait Islander people in Australia to 2031 (2.4% per year) [51053].

Queensland is the most decentralised of the mainland states in Australia, with just under half the population living in the capital city of Meanjin/Brisbane (49.8%) compared with 68% in other states [51049], and more than 95% of land area classified as rural and remote [32736]. Almost one in ten First Nations peoples in Queensland live in the Brisbane Local Government Area (LGA), and this makes up 1.8% of the Brisbane LGA population [51054].

The LGAs with the greatest proportion of First Nations peoples are Cherbourg (96.4% of the total LGA population), Yarrabah (95.9%), Wujal Wujal (93.5%), Woorabinda (91.6%) and Palm Island (91.4%) [51054]. Of these, Yarrabah, near Gimuy/Cairns, is recognised as the largest discrete First Nations community in Australia [51059].

Queensland has a relatively young First Nations population, with around a third (34%) aged under 15 years, in comparison to 18.1% of the remaining population in Queensland [51060]. In contrast, only 5.2% of the First Nations population is aged 65 years and over, in comparison to 17.2% for other Queenslanders [51060].

In this section, you will find information on First Nations peoples in Queensland in specific population groups such as babies, children, young people, older people, those in the justice system, women, men and members of the LGBTIQA+SB community.

Infectious diseases are those that are caused by bacteria, viruses or other microorganisms, and include diseases like hepatitis, rheumatic fever, tuberculosis, meningococcal disease, pneumonia and sexually transmitted infections (STIs). Various vaccinations are recommended for babies and children, young people and adults.

Free childhood vaccination programs in Queensland help to reduce both the incidence of these infections, and serious outcomes that can result from vaccine-preventable diseases [51058]. This means children are protected against infectious conditions like measles, mumps, rubella, hepatitis B and polio. Aboriginal and Torres Strait Islander (First Nations) children in Queensland also receive extra protection with vaccines for influenza, tuberculosis, meningococcal B, hepatitis A and pneumococcal [51058] and various campaigns encourage and remind families to vaccinate their children for good health, such as the Bubba Jabs initiative by Queensland Health [38416].

Certain infectious diseases have higher incidence rates amongst First Nations young people and adults, when compared with other Queenslanders. This disparity is an effect of socioeconomic factors and compounded by issues including access to culturally safe and appropriate healthcare. These include blood borne viruses (BBVs) such as hepatitis B and hepatitis C, and some sexually transmissible infections (STIs) such as chlamydia, gonorrhoea and syphilis [41222]. The high prevalence of STIs such as chlamydia and gonorrhoea among First Nations peoples, particularly those living in remote communities, requires coordinated, culturally appropriate efforts to promote prevention, increase awareness and encourage testing [50518]. Resources such as the Sexual health yarning our way: women’s business and the Sexual health yarning our way: men’s business factsheets produced by the Queensland Aboriginal and Islander Health Council (QAIHC), assist these efforts to increase awareness and prevent infection [49551][49550].

Another example, is the Young Deadly Free project by the University of Queensland Poche Centre for Indigenous Health, which has produced resources for First Nations young people, as well as resources for Elders, parents, youth workers and other community leaders on encouraging the community to work together on STI and BBV testing [37100].

Aboriginal and Torres Strait Islander (First Nations) peoples are affected by chronic diseases at higher rates, and at younger ages [51055], than other people in Australia. The burden of chronic disease is also higher for people living in regional and remote areas when compared to urban centres [42443].

Chronic conditions that disproportionately affect First Nations peoples include heart and circulatory diseases (such as ischaemic heart disease (IHD) and rheumatic heart disease), diabetes, respiratory diseases (such as chronic obstructive pulmonary disease (COPD) and asthma), kidney diseases and some cancers [51056]. These chronic conditions lead to higher rates of hospitalisations and contributes to the gap in life expectancy between First Nations peoples and other Australians. This disparity is an effect of socioeconomic factors and historical trauma, compounded by issues in being able to access culturally safe and appropriate healthcare [50938].

Reducing the disparity of chronic disease rates between First Nations peoples and other Queenslanders is a priority for the Queensland Government. For example, concerted efforts over the last decade have seen reductions in the burden of cardiovascular disease for First Nations peoples [51057].

The Queensland Cancer Strategy 2024, co-developed by the Queensland Aboriginal and Islander Health Council and Queensland Health, acknowledges the disparity in health outcomes for First Nations peoples and other Queenslanders, particularly those living in remote areas, and provides a framework that integrates health, cultural and social determinants with the aim of addressing the gap in cancer care outcomes for First Nations peoples [49641].

The term social and emotional wellbeing (SEWB) is used by many Aboriginal and Torres Strait Islander (First Nations) peoples to describe the social, emotional, spiritual and cultural wellbeing of a person [33834][27487]. SEWB can interact with and influence mental health, however as a concept, it offers a more holistic understanding of a person’s wellbeing that acknowledges social, cultural, political and historical contexts [27487]. As such, SEWB recognises that factors such as connection to family/kinship, community, culture and Country are interconnecting and central to wellbeing for First Nations peoples [27487][38676][38123].

SEWB also recognises that past events and policies have negatively impacted on First Nations peoples and their wellbeing [38123][43078], and therefore the strength-based and holistic nature of SEWB can provide a protective buffer against psychological distress [29074].

Factors identified as enhancing SEWB for First Nations peoples include maintaining connection to and caring for Country, spirituality, ancestry and kinship networks, as well as strong community governance and cultural continuity [29074]. Renewal of First Nations cultures and knowledge systems and the capacity for self-determination are being increasingly recognised as fundamental to healing and supporting SEWB [41496][50610].

Produced by the Queensland Mental Health Commission in partnership with the Healing Foundation, Leading healing our way: Queensland Aboriginal and Torres Strait Islander healing strategy 2020-2040, expands on these factors by including priorities such as truth telling, eliminating racism and discrimination, and system reform to reduce trauma and support healing and wellbeing [47835].

Queensland Health’s Evolve Therapy Services have produced a set of social and emotional wellbeing cards designed to facilitate more meaningful conversations between mental health clinicians and their First Nations clients. The cards allow clinicians to better understand First Nations perspectives of SEWB to improve support for their clients and families [42246].

Other examples that support SEWB and mental health, include the Queensland Aboriginal and Islander Health Council’s (QAIHC) resources and programs that support families whose lives are affected by problematic substance use and its impact on mental health. The Eyez on ice resource was developed in consultation with community, sector and clinical experts across Queensland with the aim of assisting health professionals and families to support people impacted by the use of crystal methamphetamine (ice), by providing strategies to reduce harm and increase safety for families [45017].

In partnership with Apunipima Cape York Health Council, QAIHC has also re-contextualised Queensland’s Breakthrough for Families program, to develop the Breakthrough Our Way program for First Nations families. Breakthrough Our Way provides voluntary information sessions for families, significant others and the broader community whose lives are affected by ice and other drugs.

Determinants that affect health and wellbeing include socioeconomic factors (such as education level, employment, income), geographic factors (such as levels of remoteness), environmental factors (such as housing, overcrowding and passive smoking) and behavioural factors (such as alcohol consumption, physical activity and diet) [29647].

For Aboriginal and Torres Strait Islander (First Nations) peoples, the determinants of health and wellbeing can also be extended to include factors such as family/kinship, connection to community, cultural identity, language, traditional knowledge, connection to and caring for Country, and self-determination. These are interrelated and have been identified as having a positive impact for First Nations peoples and communities [47098][35507][43645]. They can also help to reduce the negative impacts of biomedical and psychological factors caused by racism and historical events, including the intergenerational trauma experienced due to the forcible removal of children from their families (Stolen Generations) [19042].

Conditions experienced before birth and during infancy also play a major role in influencing health throughout a person’s life [29647]. Therefore, strategies that focus on maternal and child health, early intervention and family support, will potentially have a greater impact on the health of individuals throughout their lives. First Nations-led services such as the Birthing in Our Community program, have helped to improve health outcomes for mums and bubs in Meanjin/Brisbane.

Another example of addressing the determinants of health is Queensland Health’s commitment to improve environmental health outcomes across the state. First Nations peoples are disproportionately affected by the diseases associated with environmental health due to factors such as the remoteness of some communities and the lack of adequate housing and home health hardware [42074]. The Queensland First Nations Environmental Health Strategy 2024-29 supports Queensland’s Aboriginal and Torres Strait Islander Environmental Health Program across the state’s 16 discrete communities [50035], and various Aboriginal and Torres Strait Islander community controlled organisations run healthy housing and hygiene programs to support good health.

Welcome to the HealthInfoNet topic of cultural mentoring. This section provides a range of publications and resources about cultural mentoring. The resources and publication will assist both mentors and mentees.

This section aims to keep you updated with the latest information on Coronavirus (COVID-19).

Yarning Safe’N’Strong is a helpline for Aboriginal and Torres Strait Islander people who can call 1800 959 563 to have a yarn about their wellbeing. This services is provided by the Victorian Aboriginal Health Service.

You will find updates from the:

• Australian Government Department of Health, Disability and Ageing and Government state and territory websites
• National Aboriginal Community Controlled Health Organisation.

The Department of Health, Disability and Ageing has a section on COVID-19 vaccination for Aboriginal and Torres Strait Islander people. To find a location to have a vaccination add your location into the Vaccine Service Finder.

Healthdirect provides information about COVID-19 for Aboriginal and Torres Strait Islander people.

Healthdirect resources include Get COVID Clarity.

The Australian Department of Health, Disability and Ageing has information on Oral treatments for COVID-19, including information about the antiviral medicines approved for use in Australia for people with COVID-19. Antiviral treatments are need to start within five days of COVID symptoms starting or testing positive for COVID-19. To find out if you are eligible for Antiviral treatments click here.

The Australian Health Practitioner Regulatory Agency and the National Boards, together with the Australian Government and the Health Professions Accreditation Collaborative Forum, have set National principles for clinical education during COVID-19.

The Australian College of Nursing and Australian Government has developed the COVID-19 Vaccine Training Program available via an e-learning platform at no cost, a link is provided on this webpage.

Family, kinship and community are central to a holistic understanding of the social and emotional wellbeing (SEWB) of Aboriginal and Torres Strait Islander people [42770] [43078] [29064].

Family and kinship

Within Aboriginal and Torres Strait Islander models of SEWB, family and kinship are very important relational domains, and kinship is one of the principles that guides the current national SEWB framework [33834] [32777] [28917].

Kinship systems provide each person with a defined role (based on age, gender and other factors), and serve to link people via duties of care [35856]. Children are attached to and cared for by many adults, including grandparents, aunties, uncles and older siblings [29064] [28917]. Elders are respected [32777] [42770].

While the kinship system was more prevalent in traditional pre-colonised society, family and kinship networks remain an important part of the lives of Aboriginal and Torres Strait Islander people [29064].

The disruption of family life is therefore a risk factor for poor SEWB [42770] [33834]. Historical disruptions to family life under past government policies included the removal of children and the deliberate fragmentation of kinship systems [29064]. Current disruptions include the experience of family violence, child abuse and neglect, the absence of family members, and children in out-of-home care [42770] [33834].

A strong and healthy connection to family is a protective factor for SEWB [42770] [33834]. Connection – when it has been disrupted – can be restored by spending time with Elders, developing healthy relationships, connecting with family history and participating in parenting and family programs [42770]. The current national SEWB framework advocates for a number of specific actions to strengthen and support Aboriginal and Torres Strait Islander families [33834].

Community

For many Aboriginal and Torres Strait Islander people, knowing and being part of particular Aboriginal and/or Torres Strait Islander communities is an important part of identity [28916].

As well as being important to identity, communities can be sources of support and resilience, and this support can enhance and promote an individual’s SEWB [33834]. Both the current SEWB framework and the Aboriginal and Torres Strait Islander models of SEWB on which it is based identify connection to community as important to a person’s wellbeing [33834] [28917] [32777].

Conversely, disrupted connection to community is identified as a risk factor for poor SEWB [42770] [33834]. Events or experiences that can disrupt a person’s connection with their community include isolation, lateral violence, substance use and family feuding.

Communities that are empowered and cohesive are best able to support the SEWB of individuals and families [33834] [29065]. Self-determination, community control, cultural revitalisation and community healing have been identified as crucial strategies for empowering and strengthening communities [42770] [33834] [29065] [29074].

Under the range of holistic frameworks and models that have defined social and emotional wellbeing (SEWB) for Aboriginal and Torres Strait Islander people, Country, culture and spirituality play important roles to the health and wellbeing of Aboriginal and Torres Strait Islander people [27487] [40655] [35856]. Country, culture and spirituality may have different meanings and significance to Aboriginal and Torres Strait Islander people and communities across Australia [43078], and can be dependent on factors such as age, geographical location and cultural knowledge [33834].

Rather than viewing Country, or land, as a physical environment, Aboriginal and Torres Strait Islander people consider Country as a deeply symbolic and spiritual place [27487]. The connection between person and Country reinforces Aboriginal and Torres Strait Islander peoples’ identity and sense of belonging [33834]. Connection to Country can be expressed or maintained by, but not limited to [43533] [40745] [30843]:

• caring for Country
• birthing on Country
• spending time on Country
• ‘finishing up’ and/or being buried on Country.

Aboriginal and Torres Strait Islander people’s connection to culture refers to the preservation, continual expression and practice of Aboriginal and Torres Strait Islander cultural heritage [27487] [33834]. Sustaining an active and healthy relationship with culture strengthens identity, builds resilience and provides opportunities to connect with the past [39792]. Cultural expression may include [35856] [27487] [39792]:

• language and storytelling
• dance and ceremony
• music and art
• kinship.

Spirituality is a complex concept that connects the past, present and future [20914]; it encompasses a person’s relationship with other people, the living (e.g. animals) and non-living (e.g. tides) life forces. The spirituality of Aboriginal and Torres Strait Islander people can be expressed in many ways, including art, song, story, ceremony and Dreaming [27487]. Dreaming refers to the understanding that the world was created by ancestral spirits [35856]; Country and spirituality are therefore strongly linked and central to the identity of many Aboriginal and Torres Strait Islander people. The merging of religions, cultures and technologies means that concepts of Aboriginal and Torres Strait Islander spirituality have evolved and vary among the diverse cultural groups across Australia [27487].

It is important for health practitioners to recognise the significance of Country, culture and spirituality for Aboriginal and Torres Strait Islander people, and to understand that when these domains become disrupted, culturally appropriate intervention is required [27487]. There are many successful programs in Australia which support Aboriginal and Torres Strait Islander people to (re) connect to Country, culture and spirituality [35856]. Research has demonstrated that connecting to Country, culture and spirituality is fundamental to the resilience and positive SEWB of Aboriginal and Torres Strait Islander people [41496].