Closing the Gap on Aboriginal and Torres Strait Islander disadvantage

1. Closing the Gap on Aboriginal and Torres Strait Islander disadvantage Close the Gap day seminar University of Melbourne 21stMarch, 2013 A/Professor Jane Freemantle

2. Overview • Consider the pieces of the puzzle • History • Demographics • Some statistics • Getting it right • Put the pieces of the puzzle together • Stolen generation • Loss of lifestyle and culture • Poor living environment • The issues are known, the solutions are achievable

3. In the beginning:……

4. Previous population counts • It is estimated that prior to the arrival of British settlers, the population of Indigenous Australians was approximately 318,000–750,000 across the continent. • By 1900 the recorded Indigenous population of Australia had declined to approximately 93,000 • 30th June 2006, 517,200 people identified as Aboriginal and Torres Strait Islanders, 1301.0 – Year Book Australia, 2002Australian Bureau of Statistics 25 January 2002

5. Current population • 30th June 2011, 548,370 people identified as Aboriginal and Torres Strait Islanders, of these: • 90% identified as Aboriginal only • 6% as Torres Strait Islander • 4% as both Aboriginal and Torres Strait Islander • Number represents ~ 2.5% of the Australian population (An increase of 20.5 per cent more Australians identified as Aboriginal and Torres Strait Islander than in the 2006 Census) • Definition: “An Aboriginal or Torres Strait Islander is a person of Aboriginal or Torres Strait Islander descent who identifies as an Aboriginal or Torres Strait Islander and is accepted as such by the community in which he or she lives” (1983 the High Court of Australia)

6. Getting it right! • Currently, there are no data of sufficient quality to determine the number of Aboriginal and Torres Strait Islander births or deaths in Victoria Australia: • There is a significant under ascertainment of Aboriginal and Torres Straits Islander births as information describing mothers’ Indigenous status only is collected at the time of the birth, fathers’ Indigenous status is NOT included • Accurate and complete ascertainment of all births is necessary to provide: • Reliable information to inform policy and program development, to evaluate policies aimed at improving service delivery and health status and to assess the effectiveness of programs and interventions. • A denominator from which to calculate accurate mortality rates for infants, children and young people.

7. Victorian Aboriginal Child Mortality Study, 1988-2008 Inconsistent and inaccurate recording of ‘Indigenous status’

9. Population distribution

10. Aboriginal and Torres Strait Islander Australia

11. Births by mother’s residential remoteness area, 2008

12. Population profile by Indigenous status, age and sex, 2011

13. Stolen Generation Loss of Lifestyle & Culture Poor Living Environment Where to from Here? Piecing the Puzzle of Plight together

15. The Stolen Generations • Official government policy 1909 - 1969 (=60yrs!) • Aboriginal children who were ‘not of full blood’ were raised as ‘white’ and taught to reject their Aboriginality • Poor education was provided; Aboriginal children employed as labourers or servants • Many parents never saw their children again & siblings were deliberately separated This is not ancient history! Today there are Aboriginal adults as young as their late 40’sand50’swho are members of the Stolen Generations

16. Stolen Generation Proportion of Year 3 students who achieve the numeracy benchmark 100.0 90.0 80.0 70.0 60.0 Percent 50.0 All Students 40.0 Indigenous students 30.0 20.0 10.0 0.0 2001 2002 2003 2004 2005 Proportion of Year 7 students who achieve the numeracy benchmark 90 80 70 60 50 Percent 40 30 All Students 20 Indigenous students 10 0 2001 2002 2003 2004 2005 Education Around Indigenous 10,000 students enrolled across Australia (0.7% ~2.9% total pop)

17. Tertiary graduates • 9 Aboriginal dentists, • a handful of pharmacists, • 153 medical practitioners, and 218 medical students – !1ENT specialist DR Kelvin Kong (2008) no surgeons or physicians – • 16 practisinglawyers and 2 Indigenous magistrates no judges. • 30 qualified engineers

18. Loss of Lifestyle & Culture Piecing the Puzzle of Plight together

19. Loss of Lifestyle & Culture

20. Loss of Lifestyle & Culture Low birthweight babies per 100 livebirths, by Aboriginal status of the mother and state/territory, 2003-2005 combined Source: AIHW, Aboriginal & Torres Strait Islander Health Performance Framework 2008 Report

21. Loss of Lifestyle & Culture Infant mortality rates by Aboriginal status, NSW, Qld, SA, WA & NT combined Source: ABS, Deaths Australia 2009

22. RR 5.60 Mortality attributed to SIDS, WA born infants, 1980-2004 RR 8.22 RR 7.74 RR 2.74 RR 8.22 RR 7.20

23. RR =2.3 >4-<14 yrs non-Indigenous Indigenous Age groups at death RR=2.9 1-<4yrs 0 20 40 60 80 Rate per 100,000 infant survivors Source: SCRGSP 2007 Age-specific death rate, and relative risk (RR) for Indigenous compared with non-Indigenous children, 2001-2005

24. Rates of children <4 years hospitalisedfor injuries, 2004-2005 300 250 200 Rate per 1000 150 100 50 0 Indigenous non-Indigenous Children Aged <4 years Source: SCRGSP 2007

25. Poor Living Environment Piecing the Puzzle of Plight together

26. Poor Living Environment Aboriginal people are 20 times more likely to be homeless. (Australian Government Footprints in time - The longitudinal study of Indigenous children)

27. Poor Living Environment Overcrowding In 2008: • 92,700 or 31% of Aboriginal and Torres Strait Islander children and youth lived in overcrowded housing • In remote areas, more than half (58%) of all children and youth lived in overcrowded housing. NOTE: ‘children' refers to people aged 0–14 years. The terms 'youth' and 'young people' refer to people aged 15–24 years. Data presented are from the ABS National Aboriginal and Torres Strait Islander Social Survey, 2008 (cat. no. 4714.0).

28. Poor Living Environment Infectious Diseases Aboriginal and Torres Strait Islanders experience: • a greater burden of communicable and non-communicable infectious diseases • the highest rates of bacterial respiratory diseases reported in the literature • an incident rate of meningococcal infection of approximately six times that of the non- Indigenous population (WA) • a high prevalence of gastroenteritis; major cause of hospitalisation of infants (WA) • a significantly higher rate of invasive pneumococcal disease compared with non-Indigenous Australians

29. Poor Living Environment • Ear disease can reduce a child’s ability to understand what’s being taught in school • Poor education leads to poor employment and lower income • = Long-term cycle of disadvantage

30. Poor Living Environment Hypothesized risk pathways associated with Otitis Media & Juvenile Justice Suicidal behaviour Alcohol & Drugs Early contact with Juvenile Justice Depression Low self-esteem Increasing psychosocial difficulties Acute Stress Significant Loss School & learning difficulties Peer problems Poor housing, overcrowding & smoking Negative thinking patterns Deafness Otitis media Difficulties within the family Genetic factors Low Birth Weight Ref. Silburn & Freemantle Poor diet & nutrition Poor maternal diet, infections, alcohol, drug use & smoking Pregnancy Birth Infancy Childhood Adolescence Time

31. Piecing the Puzzle of Plight together Loss of Lifestyle & Culture Stolen Generation Poor Living Environment Where to from Here?

32. Where to from Here?

33. Where to from Here? Understand… To work effectively with Aboriginal young people, their families and their communities, understand: • The impact of non-Aboriginal people on the lives of Aboriginal people • The continuing disadvantage facing Aboriginal young people • A holistic view of health and wellbeing • The importance of self determination and working in partnership with Aboriginal communities • How to make your service culturally appropriate for Aboriginal people.

34. Where to from Here? A poster by Chelsea Westlake of Cosmo Newberry

35. Where to from Here?

36. Education Attainment Birth Weight Unemployment Poverty Alcohol Abuse Infant Mortality Lifestyle Disease Housing Environment Cultural Competence Efficient/Effective Service Provision Indigenous Service Providers RHD Ear Disease Resp. Disease Overcrowding

37. ‘CLOSE THE GAP’ in Indigenous disadvantage