Introduction

The Overview provides a comprehensive summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people in Australia (of all ages, where data is available).

The topics included in the Overview are based on the original topics included on the HealthInfoNet website when it was established. Over the years as additional funding was obtained, and in consultation with HealthInfoNet networks, more topics were considered and added. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

What is new?

In this year’s Overview we have included Closing the Gap (CTG) ‘target boxes’ which indicate where health and wellbeing topics align with any of the 17 CTG socio-economic outcome areas. This inclusion allows readers to quickly identify where the reported health topics align with national policy that has been led by Aboriginal and Torres Strait Islander people.

The HealthInfoNet continues to develop our capacity to accurately and authentically represent the data and statistics that impact Aboriginal and Torres Strait Islander people and communities. It is a journey that we share with other data-driven organisations such as the Australian Bureau of Statistics (ABS) and the Australian Institute of Health and Welfare (AIHW) [1] and is buoyed by the recent release of the Framework for Indigenous Data Governance [2]. Included in this year’s Overview is a statement on how the principles of Aboriginal and Torres Strait Islander Data Sovereignty have been embedded in the Overview.

Structure

The initial sections of the Overview provide information about the social and cultural determinants of Aboriginal and Torres Strait Islander peoples’ health. Prefacing information on social and cultural determinants reflects the importance of context in interpreting Aboriginal and Torres Strait Islander health statistics. The subsequent sections are about specific health conditions and risk/protective factors that contribute to the overall health of Aboriginal and Torres Strait Islander people as well as various measures of population health status. These sections comprise an introduction about the condition, alignment with associated CTG target (where appropriate), and evidence of the current status of the condition or risk/protective factors and burden of disease. Information is provided for states and territories, Indigenous Regions and remoteness, and for demographics such as sex and age when it is available.

Where possible, information is detailed for individual states and territories: New South Wales (NSW), Victoria (Vic), Queensland (Qld), Western Australia (WA), South Australia (SA), Tasmania (Tas), the Australian Capital Territory (ACT) and the Northern Territory (NT).

Aboriginal and Torres Strait Islander Data Sovereignty

The Overview should be read in the context of our ongoing commitment to presenting data that empowers Aboriginal and Torres Strait Islander communities while acknowledging Aboriginal and Torres Strait Islander peoples’ ongoing efforts to improve the quality of current data sources in Australia.

All data presented in the Overview is secondary data meaning that it has been collected by organisations outside of the HealthInfoNet. With this in mind, we have applied the principles of the Maiam nayri Wingara Indigenous Data Sovereignty Collective to the Overview, which state that:

Aboriginal and Torres Strait Islander peoples have the right to:

1. exercise control of the data ecosystem including creation, development, stewardship, analysis, dissemination and infrastructure
2. data that are contextual and disaggregated (available and accessible at individual, community and First Nations levels)
3. data that are relevant and empowers sustainable self-determination and effective self-governance.
4. data structures that are accountable to Indigenous peoples and First Nations
5. data that are protective and respects our individual and collective interests [2].

The list below outlines how the principles of Indigenous Data Sovereignty are embedded within the Overview with the caveat that only secondary data is presented:

• The HealthInfoNet relies on advice from its Advisory Board on the direction of the Overview.
• A post-publication peer review period enables readers to provide feedback.
• Where available, regional data are included; examples include The Roadmap to Close the Gap for Vision project (eye health); Indigenous Regions (ear health and hearing); Mayi Kuwayu study (SEWB) and Kimberley-specific data (skin health).
• Where possible, the HealthInfoNet has included and highlighted data that has been collected by Aboriginal and Torres Strait Islander-driven research.
• A number of sections include the results of our own analyses of data obtained from a variety of sources. For example, data are requested from ANZDATA for the kidney health topic. This request is assessed by an Indigenous Reference Group who decide which data will be released for analysis.
• Information on social determinants and the context of Aboriginal and Torres Strait Islander health is provided at the beginning of the report and, where possible, at the start of each health topic section.

Additionally, Table 1 (below) outlines how information contained within the Overview aligns with Indigenous health data needs.

Table 1: Indigenous data needs aligned with Overview, 2024

Indigenous Data Needs	How need is met with the Overview
Lifeworld Data Data to inform a comprehensive, nuanced narrative of who we are as peoples, of our culture, our communities, of our resilience, our goals and our successes.	·       Following on from previous editions of the Overview, less reliance is placed on comparisons between Indigenous and non-Indigenous data. ·       ‘Target boxes’ have been included to highlight where reported data aligns with a national health priority area outlined in the CTG targets. ·       The Overview incorporates a strengths based approach where possible. This is achieved by including data on protective factors, cultural determinants, and improvements in the health status of Aboriginal and Torres Strait Islander people.
Disaggregated Data Data that recognise our cultural and geographical diversity and can provide evidence for community-level planning and service delivery.	·       Information is provided for states and territories, Indigenous Regions and remoteness, and for demographics such as sex and age when it is available. ·       Where possible, information is detailed for individual states and territories: NSW, Vic, Qld, WA, SA, Tas, the ACT and the NT.
Contextualised Data Data that are inclusive of the wider social structural context/complexities in which Indigenous disadvantage occurs.	·       Cultural and social concepts include discussion of social determinants of poor health. ·       Introduction sections on disease and injury rates include the contexts which continue to contribute to these. ·       Inclusion of a case study on the health impact on the 2023 Voice to Parliament referendum.
Indigenous Priority Data Data that measure not just our problems but data that address our priorities and agendas.	·       ‘Target boxes’ have been included to highlight where reported data aligns with a national health priority area outlined in the CTG targets.
Available Amenable Data
Data that are accessible and amenable to our requirements.	·       Where available, listing the Indigenous Data Governance mechanisms which oversee the sources of data used in the Overview. This provides readers an easy-to-use access point for assessing the level of governance attached to each dataset.

The Overview draws data from a number of sources including data on pregnancy, births and certain cancers. Some of these sources use the term ‘women’ and ‘men’ to refer to sample participants. In reporting these statistics in the Overview we use the terminology that is consistent with the data source, and we have taken care to identify whether the original data source was referring to sex or gender. However, we acknowledge that ‘woman’ and ‘man’ are only two genders and trans and non-binary peoples are oftentimes ignored in statistical data collection as well as gender and sex being conflated in reporting of some datasets. For more information on inclusive language please see the Edith Cowan University inclusive language guide [4].

Sources of information

The Overview provides the latest up-to-date data on the health status of Aboriginal and Torres Strait Islander people. For readers interested in historical health data for selected health conditions, these data are available in previous editions of the Overview.

Research for the Overview involves the collection, collation and analysis of a wide range of relevant information. Sources include government reports, particularly those produced by the ABS, the AIHW, the Health Chief Executives Forum [formerly the Australian Health Ministers Advisory Council (AHMAC)] and the Steering Committee for the Review of Government Service Provision (SCRGSP). Important additions to the regular ABS and AIHW publications are a series of special reports that bring together key information about Aboriginal and Torres Strait Islander health and related areas:

• Reports in the Aboriginal and Torres Strait Islander health performance framework series with substantial detailed analyses, prepared by AHMAC from 2006 to 2020 and from then by the AIHW and National Indigenous Australians Agency.
• Reports on government services, produced by the SCRGSP and published annually by the Productivity Commission since 2003.
• Overcoming Indigenous disadvantage (OID) reports, produced by the SCRGSP and published biennially by the Productivity Commission, for the period 2003-2020¹.

• This Overview also draws on information from the main administrative data collections (such as the birth and death registration systems and the hospital inpatient collections) and national surveys, for example, the National Australian Aboriginal and Torres Strait Islander health surveys. Information from these sources has been published mainly in government reports, particularly those produced by the ABS, the AIHW and the SCRGSP. The Overview also relies on a wide variety of other information sources including registers for specific diseases and other conditions; regional and local surveys and epidemiological and other studies examining particular diseases, conditions and health determinants. Information from these sources is disseminated mainly through journals and similar periodicals, or in special reports, such as the annual reports of the Kirby Institute and ANZDATA.

We are pleased that many of these data sources are actively engaged in improvements in Aboriginal and Torres Strait Islander data sovereignty and governance:

• ANZDATA Indigenous Data Sovereignty has been a key project of the ANZDATA Aboriginal and Torres Strait Islander Health Working Group.
• Aboriginal and Torres Strait Islander projects undertaken at the Kirby Institute by individual Aboriginal and Torres Strait Islander researchers aim to integrating Indigenous methodologies, cultural governance, frameworks and principles of data sovereignty into their programs.
• The AIHW provides disaggregated data for CTG through the Regional Insights for Indigenous Communities. The ABS also provides this data by Data by region and their TableBuilder.
• In 2022, the ABS engaged an independent agency to conduct a private impact assessment on the privacy implications of updates to the Person Level Integrated Data Asset, formerly the Multi-agency data integration plan (MADIP). This process included the concern of self-governance for Aboriginal and Torres Strait Islander data. The ABS noted that they will view national and international best practice processes when implementing proposed updates to MADIP. They are also taking an active role in the government’s consideration of immersing Indigenous Data Sovereignty into the governance of Aboriginal and Torres Strait Islander data in Australia.
• The AIHW and ABS both hold individual membership roles in the Data Champions Network and the Deputy Secretaries Data Group, formed by the Australian Public Service to develop and implement the Framework for Governance of Indigenous Data.

Footnotes

1 The future of the OID is being considered in the context of reporting under the National Agreement on Closing the Gap.