BackgroundThis is the fourth report against the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) and the first report based on the revisions to the framework endorsed by the Australian Health Ministers' Advisory Council (AHMAC) in 2011 (see Figure 1).
The HPF was designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) and will be an important tool for developing the new National Aboriginal and Torres Strait Islander Health Plan. The HPF monitors progress in Aboriginal and Torres Strait Islander health outcomes, health system performance and the broader determinants of health. The health of Aboriginal and Torres Strait Islander peoples is improving for a number of measures, although there remain many areas where further concerted effort will be needed to achieve improvements in health outcomes.
Data quality limitations hamper our ability to monitor Indigenous health and the performance of the health system (see Technical Appendix). Initiatives to improve data quality have been introduced in recent years, and are yielding results. However, caution is still required in interpreting these findings. Note: this report includes revised mortality data for the period 2007, 2008 and 2009 due to revisions in the WA mortality data for this period.
Council of Australian Governments (COAG) TargetsIn December 2007, COAG agreed to a partnership between all levels of government to work with Aboriginal and Torres Strait Islander peoples to close the gap in Aboriginal and Torres Strait Islander disadvantage. During 2008 and 2009 new National Partnership Agreements were developed covering areas such as Indigenous early childhood, health, education and employment. The information in this report mainly relates to the period leading up to these agreements and for many of these initiatives it is still too early for the health outcome data to reflect the impact of this work. Since the introduction of the National Partnership on Closing the Gap in Indigenous Health Outcomes there has been a significant increase in health assessments and chronic disease management items claimed through Medicare. Given that two thirds of the current gap in health outcomes is due to chronic disease, these improvements in the detection and management of chronic disease are important.
COAG set six targets in 2008 including:
Closing the life expectancy gap within a generation
- The gap in life expectancy at birth between Aboriginal and Torres Strait Islander peoples and other Australians for 2005–07 was estimated at 11.5 years for males and 9.7 years for females.
- In the absence of new data on life expectancy (due to be released in late 2013), mortality rates provide an indication of progress. The graph below shows mortality rates from 1998 to 2010 and an indicative trajectory of mortality rates required to reach the target by 2031. This graph shows there has been a significant decline in Indigenous mortality rates in the last decade, however Indigenous rates are currently twice the non-Indigenous rate and this decline would need to accelerate to reach the target.
Figure 2—Total mortality rates by Indigenous status, NSW, Qld, WA, SA and the NT, 1998–2031
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Halving the gap in mortality rates for Indigenous children under five within a decade
- In 2008, the Aboriginal and Torres Strait Islander child mortality rate was 213 per 100,000 compared to 101 per 100,000 for non-Indigenous children. This makes the baseline gap 112 per 100,000. Note: the 2008 baseline has been revised since the last report due to revisions in the WA mortality data.
- The graph below shows child mortality rates from 1998 to 2010 and indicative trajectories required to meet the target by 2018. The 2009 and 2010 rates are within the range required to meet the target.
Figure 3—Child mortality rates by Indigenous status, NSW, Qld, WA, SA and the NT, 1998–2018
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