Global, long- term research by the UN World Health Organisation shows that living circumstances and quality of life are the fundamentals of health and life expectancy for all people, regardless of their culture or location. These fundamentals are known as the “social determinants of health”.[1]

The likelihood of serious ill health and short life escalates in direct relation to social and economic disadvantage. Disadvantages include few assets, low income, little education, insecure or dissatisfying employment, poor housing and parenting under difficult conditions. Also, people who feel excluded from mainstream society are likely to have poorer health.

Health through life is founded in infancy and childhood. Social and economic poverty, especially inadequate nutrition impedes physical and mental development, which is associated with chronic adult health problems, poor education, unemployment or low-status jobs.

Alcohol, drug and tobacco misuse are destructive to health, but are also closely related to social and economic disadvantage. Economic and social disadvantages cause increased dependence on alcohol, drugs and tobacco which exacerbates the factors that led to their initial misuse. Poor housing, low income, single parenthood, unemployment and homelessness are all associated with high rates of smoking, a major cause of ill health.

All Australians, not just the Indigenous, are affected by these social determinants. Most of these factors are not amenable to individual choice: they are not “their own fault”. We need to change the founding causes of poor health for all Australians, especially in Indigenous communities, where health problems are extreme.

The following statistics relating to key indicators of Indigenous social and economic disadvantage show the breadth and extent of action required to stem the current crisis in Indigenous health.

Incarceration

While 2.4% of the population [2], Indigenous people account for 19% of adult prisoners and 41% of juveniles in detention. [3]

Unemployment

Indigenous unemployment is likely to increase from 39% to 47% by 2006. [4]

Unemployment of all Australians has steadily decreased since 1994 [5], currently at 6%, the lowest since the 1960s. [6]

53% of Indigenous people in rural areas earn their income through CDEP (‘work for the dole’). [7]

Income

The median income for Indigenous people is 40% lower than for the total population. [8]

Home Ownership

Only about 30% of Indigenous Australians own their own homes, compared with 70% for the mainstream population. [9]

Infrastructure

21 communities lack water, 80 lack electricity and 91 lack sewerage.

Education

Fewer than 30% of Indigenous children finish high school compared with 73% of the overall Australian population. [10]

End Notes

[1]. Richard Wilkinson and Michael Marmot, Social Determinants of Health: the Solid Facts, World Health Organisation Regional Office for Europe, 1998.

[2]. 458,500 in 2001. ABS 4713.0, Population characteristics: Aboriginal & Torres Strait Islander Australians 2001, Commonwealth of Australia, Canberra, 2003. p.15.

[3]. Eades, Sandra J, ‘Reconciliation, social equity and Indigenous health: a call for symbolic and material change’. Medical Journal of Australia 2000; 172: 468-9.

[4]. Ibid.

[5]. www.abs.gov.au, Australian Social Trends 2003, Work: National summary tables.

[6]. The Australian, Saturday 7 Feb. 2004, p.3.

[7]. Ibid.

[8]. Australian Indigenous HealthInfoNet (1998). Australian Indigenous HealthInfoNet overviews: selected social indicators. [20 Jan 2004].

[9]. Commonwealth Grants Commission, Report on Indigenous Funding 2001, pp 146-147.

[10]. Australian Bureau of Statistics, Australian Social Trends 2002, Education - Participation in Education: Education of Aboriginal and Torres Strait Islander peoples. www.abs.gov.au..