Aboriginal and Torres Strait Islander Health Performance Framework - 2010

Tier 2: Determinants of Health

Page last updated: 26 May 2011

Tier 2, Determinants of Health, includes measures that convey the impact on health from environmental and socioeconomic factors, community capacity, health behaviours and person-related factors. Many of these issues do not relate directly to the activities of the health system, but they impact on health outcomes and how people access health care. Reliable information on the size and distribution of determinants of health in the Aboriginal and Torres Strait Islander population, and comparisons with the non-Indigenous population is crucial for evaluating the effects of current health and social policies; developing and prioritising strategies for health gain; highlighting areas for intersectoral action; and to support identification of research priorities. The determinants of health are now widely recognised as an essential element of health system analysis (WHO Commission on Social Determinants of Health 2008).

Measures in Tier 2 underpin health outcomes and shape how patients interact with the health system. For example, analysis has confirmed that lower levels of education, a key measure of socioeconomic status, is associated with a higher prevalence of health risk factors such as smoking and obesity (see discussion in key findings). Similarly, health status impacts on its determinants: improvements in education outcomes can be anticipated with improvements in health (see measure 1.12 Children’s hearing loss for an example of this connection).

Readers are encouraged to consider health determinants as both risk and protective factors. Improvements made in health behaviours, such as reduced smoking rates or educational attainment will flow on to improvements in how people utilise the health system and to improvements in health outcomes. Many of the measures in Tier 2, particularly those determinants grouped as ‘community capacity’ relate to the measure of ‘Community functioning’ (measure 1.14) in Tier 1. This measure illustrates the positives of health determinants, health behaviours and use of the health system in a combined analysis of strengths and capabilities using values determined by Aboriginal and Torres Strait Islander peoples.

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