The Link Between Primary Health Care and Health Outcomes for Aboriginal and Torres Strait Islander Australians

3. Changes in Indigenous health status

This review explores the evidence both domestically and internationally as to whether access to high quality primary health care is essential to enhancing Indigenous health status.

Page last updated: June 2008

In the previous chapter, we looked at the broadest scale evidence about the capacity for health systems to affect the health of populations. The international literature demonstrates that, notwithstanding the powerful effects of the social determinants of health in general, and socioeconomic class in particular, health systems do contribute significantly to the health of populations. We also find that primary health care services themselves can be credited with contributing to improved population health.

Much of the evidence in the previous Chapter compares health statistics – such as avoidable mortality – on a national level. However, as many of these studies point out, major inequalities in health exist between advantaged and disadvantaged populations within nations. In particular, the health of Indigenous peoples across the world is everywhere poorer than that of the mainstream populations amongst whom they live.

In this chapter, we turn our attention to the health of Indigenous peoples to ask a similar set of questions.

  • what does the literature say about changing patterns of health for Indigenous peoples, both internationally and in the Aboriginal and Torres Strait Islander population in Australia?
  • is there evidence that better health services (including better primary health care services) are implicated in improvements in the health of Indigenous populations overseas?
  • what evidence is there in Australia for the health system as a whole and primary health care in particular in improving Aboriginal and Torres Strait Islander health status?
In answering these questions we will follow the same standards of evidence as in the previous chapter, that is, looking at the ‘hardest’ and most comparable data by measuring changes in health through life expectancy and mortality rates. A reminder, too, that here we are concerned with evidence at a national / jurisdictional level59 – once these questions have been answered, we will then turn in the following chapter to look in more detail at local level evidence about successful primary health care programs, before attempting to define
what might be their most effective and essential components.

59 Note that in Australia, this predominantly means the data from Western Australia, the Northern Territory and South Australia.