To us, health is about so much more than simply not being sick. It's about getting a balance between physical, mental, emotional, cultural and spiritual health. Health and healing are interwoven, which means that one can't be separated from the other.—Dr Tamara Mackean, Australian Indigenous Doctors' Association [13]

Australia is the only place on the planet where Indigenous health and wellbeing are going backwards.—Sydney Morning Herald [18]

Hepatitis

Aboriginal people make up 2.5% of Australia’s population yet they are 8% of the hepatitis C population [5], a figure which could be far higher considering that many people have not been tested and could have the virus.

Less than 2% of Aboriginal and Torres Strait Islander people access treatment, and if they suffer from other diseases the barrier to seek treatment is even higher. Few of them know that hepatitis B and C could be managed and hepatitis C can be cured.

Fact Hepatitis B was first diagnosed in an Aboriginal person in 1964 [5].

For more information visit Hepatitis NSW or call the Hepatitis Helpline on 02-9332 1599 (Sydney), 1800 803 990 (NSW) or 1800 648 491 (QLD).

Cardiovascular disease

Cardiovascular Disease (CVD) is among the leading causes of death for Aboriginal people.

Almost 12% of Aboriginal people have a long-term heart or related condition, and the number of deaths from CVD is more than 3 times that of non-Aboriginal Australians [21]. The disease contributes to about one third of the life-expectancy gap.

The higher prevalence is attributed to a range of risk factors such as smoking and poor nutrition, but also socio-social factors such as social isolation and depression.

Heart disease mostly affects relatively young Aboriginal people aged between 15 and 29 [23].

Dental health

Can you believe that in the mid-1960s Aboriginal children had far better oral health than non-Aboriginal children? Today the opposite it true: Aboriginal children now have more than double the rate of dental disease as other children.[28]

Rates of dental decay in remote Aboriginal communities are often worse than 70% [10]. A 5-year study of children under 10 found that 78% of Aboriginal children had dental disease, compared with only half of other kids [4].

Such poor health is caused by a lack of fluoride in water supplies and poor diet, according to Prof Kaye Roberts-Thompson, a spokesperson for the Australian Institute of Heath and Welfare. A study suggests that socio-economic disadvantage is also playing a role [4].

“Historical factors such as forced familial separation, efforts of assimilation, on-going problems with alcohol, domestic abuse and land ownership issues… also play important roles,” the study says.

Many communities also have limited access to dental services, and children are not taught good oral hygiene.

Of children aged 12, nearly half had a history of dental decay in the permanent teeth [10]. The average number of decayed, missing and filled teeth was 1.1.

Dental problems often lead to tooth loss, difficulties with eating, problems with speech and infections that spread to other parts of the body [4]. They can also cause extreme pain that disrupts sleep, and damages concentration and self-esteem.

Disabled Aboriginal people

Aboriginal people with disabilities are among the most disadvantaged in Australian society and often face multiple barriers to meaningful participation in the community, Damian Griffis, Executive Officer of the First Peoples Disability Network, says [19].

50% of Aboriginal people have some form of disability or long term health condition.

“The prevalence of disability amongst Indigenous Australians is significantly higher, approximately twice that of the non-Indigenous population.

“This occurs for a range of social reasons, including poor health care, poor nutrition, exposure to violence and psychological trauma and substance abuse, as well as the breakdown of traditional community structures in some areas. Often this is the impact of removal from family and community.

“Indigenous Australians with disability are significantly over-represented on a population group basis among homeless people, in the criminal and juvenile justice systems, and in the care and protection system (both as parents and children).”

“Most Indigenous Australians with disabilities remain at the periphery of the disability service system,” Damian says. Many are reluctant to identify as people with disability due to how Aboriginal culture views disability.

“Culturally, our people treat disability and impairment as a part of life, a part of our community and just get on with it. In other words, it is not always an obvious step to seek out help and support from outside family networks.”

Singer Geoffrey Gurrumul Yunupingu is a prominent disabled Aboriginal person.

Drugs & dealers in Aboriginal communities

The use of methampethamine, or ice, in some communities has reached “epidemic proportions” and is at a “crisis point”, with children as young as 12 being exposed to the drug [16].

People in Aboriginal communities inject predominantly amphetamine-based drugs, whereas heroin is more prevalent among non-Aboriginal drug users. [27]

Dealers have been targeting Aboriginal youths who have an income through jobs. They sell them large amounts of ice, knowing the youths will rack up large debts, which their families need to pay.

“Ice is a huge problem in our community,” says Andrew Jackomos, Victoria’s Commissioner for Aboriginal Children and Youth [16].

If health services don’t address the crisis, HIV and hepatitis C could rapidly escalate in communities. [27]

Injecting is a major problem in Aboriginal and Torres Strait Island communities.—Dr James Ward, South Australian Health and Medical Research Institute [27]

Scabies ‘normal’ in communities

Scabies, a microscopic mite, is estimated to infest more than two-thirds of children in remote communities in their first year of life [22]. Up to 70% of all children are affected, and the infection can lead to sepsis, rheumatic fever, acute kidney disease and rheumatic heart disease.[28]

It causes an itch that can expose them to bacterial infection and ultimately to lethal rheumatic heart disease. About 18 people die of the disease each year in the Northern Territory.

Scabies and skin sores are to common that they are often considered normal [in communities],” says Prof Jonathan Carapetis, head of Menzies School of Health Research in Darwin [22].

Worryingly, crusted scabies is of particular concern, an extremely contagious infection where people are infested with thousands of mites compared with a more usual infection where a person might about 10 mites. Left untreated, around half of people with crusted scabies die within five years.[28]

To break the cycle of infestation would require medical treatment as well as changing housing, hygiene and behaviour. Such changes have to come from communities themselves to be effective.

Cancer

Cancer is the second leading cause of death for Australian children aged one to 14 years. Interestingly, Aboriginal children are 36% less likely to be diagnosed with cancer than non-Aboriginal children [15]. Mortality rates are about the same.

Leukemias and tumours of the central nervous system were the most common cancers among Aboriginal children.

Head and neck cancers in Aboriginal people are as prevalent as in non-Aboriginal people, but more than twice as likely to be diagnosed at a later stage than non-Aboriginal people [26]. Differences are less for other types of cancer.

One reason might be that many Aboriginal people are reluctant to visit their doctor or hospital, especially if it is not making them feel welcome.

Cancer Australia has developed a guide about lung cancer specifically for Aboriginal people.

Can you answer?

Question: Why are Aboriginal cancer rates 8% lower than those of other Australians (19%)?

Tell me!

More resources

The HealthInfoNet website is an award-winning resource translating knowledge and academic literature for Aboriginal health workers in Australia.

The site was started in 1997. Visit www.healthinfonet.ecu.edu.au for more information.