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Executive Summary

Improvements

Chronic disease—two-thirds of the health gap

There has been a significant decline in the mortality rate for Indigenous Australians (16%) and a significant narrowing of the gap with non‑Indigenous Australians (15%) between 1998 and 2013.

Circulatory disease mortality rates for Indigenous Australians declined by 40% between 1998 and 2012 and the gap narrowed. Circulatory disease was the most common cause of death for Indigenous Australians (25%) during 2008–12.

Kidney disease death rates (while only 3% of Indigenous deaths) also declined by 40% between 2006 and 2012 and the gap narrowed.

Risk factors

Indigenous smoking rates declined significantly by 7 percentage points (from 51% to 44%) between 2002 and 2012–13 for those aged 15 years and over.

Child and maternal health

There was a significant decline in the mortality rate for Indigenous children aged 0–4 years (31%) and a significant narrowing of the gap between 1998 and 2013.

The low birthweight rate declined by 9% between 2000 and 2011 for babies born to Indigenous mothers, and the gap narrowed.

Smoking during pregnancy declined for Indigenous mothers between 2005 and 2011 (from 54% to 50%).

Health system

Medicare services claimed by Indigenous Australians have doubled over the last decade, including increases in health assessments, chronic disease management items and overall GP care. The Indigenous rate of Medicare GP services claimed is now higher than the non‑Indigenous rate.

Since 2010, 8.8 million scripts have been issued under the PBS Co-payment Measure to Indigenous Australians.

Episodes of care delivered by Australian Government funded Indigenous primary health care organisations increased from 1.2 million in 1999–2000 to 3.1 million in 2012–13, partly reflecting expansion in the sector.

Social determinants

Between 2008 and 2012–13, the gap in the Year 12 or equivalent attainment rate for those aged 20–24 years has narrowed by 11.6 percentage points and the 2020 COAG target is currently on track.

There have also been improvements in overcrowding, homelessness and home ownership over the last decade.

Concern

Health

In 2012–13, nearly half (47%) of Indigenous Australians aged 18 years and over had a disability or restrictive long-term health condition.

The life expectancy of Indigenous Australians has improved slightly in recent years but progress will need to accelerate if the target is to be met by 2031.

Cancer death rates for Indigenous Australians have increased by 11% between 2006 and 2012, while rates for non‑Indigenous Australians have declined (5%).

There has been no improvement in the mortality rate due to diabetes or injury (including suicide and transport accidents).

In 2012–13, 11% of Indigenous adults had diabetes (3 times the non‑Indigenous rate) and 61% of those with diagnosed diabetes had high blood sugar levels indicating that the condition was not well managed.

The incidence rate of end stage kidney disease for Indigenous Australians is 7 times the rate for non‑Indigenous Australians.

Risk factors

In 2012–13, 44% of Indigenous Australians aged 15 years and over reported being a current smoker, 2.5 times the non‑Indigenous rate. Over the last decade smoking rates in very remote areas (56%) have not improved.

In 2012–13, 66% of Indigenous Australians aged 15 years and over were overweight or obese.

In 2012–13, 20% of Indigenous adults had high blood pressure and most (79%) did not know that they had the condition.

Child and maternal health

In 2011, 12.6% of babies born to Indigenous mothers were low birthweight, twice the non‑Indigenous rate. In 2011, 50% of Indigenous women smoked during pregnancy, 4 times the non‑Indigenous rate.

Health system

In 2012–13, 21% of Indigenous Australians reported having problems accessing dentists, 14% doctors, 9% counsellors, 9% other health professionals and 6% hospitals.

Indigenous Australians had lower rates of hospitalisations with a procedure recorded compared with non‑Indigenous Australians, lower rates of elective surgery and waited longer for elective surgery. Discharge from hospital against medical advice was 8 times the non‑Indigenous rate in the two years to June 2013.

Social determinants

There has been no progress on the employment target since 2008. Achievements in reading, writing and numeracy remain below the corresponding proportions for all students.

In 2012–13, 43% of Indigenous adults were in the bottom quintile of equivalised household incomes compared with 17% of non‑Indigenous adults. In 2011, 28% of homeless Australians were Indigenous.