Health status of Aboriginal Victorians

Overview

The information presented below is a summary of Aboriginal health and well-being indicators published in the Aboriginal Services Plan Key Indicators Report 2004-05. The indicators measure the service usage and outcomes for Aboriginal people in areas for which the Department of Human Services (DHS) is responsible. Indicators are presented for:

• Early child development and growth
• Early school engagement and performance
• Positive childhood and transition to adulthood
• Substance use and misuse
• Functional and resilient families and communities

These groups were developed by the OID as areas that have the potential to have significant and lasting impact in reducing Indigenous disadvantage. The data presented are drawn from a number of Department of Human Services (DHS) administrative data collections. These collections record service use and outcomes in the areas of health, housing, aged care and community services, including disability and children’s services.

A number of qualifications need to be made about the data due to incomplete identification of Aboriginal people in the census count and administrative records and the statistical challenges of reporting on a small population. For details about these data issues please see ‘About the Data’ below.

Population

In 2001, the estimated resident Aboriginal and Torres Strait Islander population in Victoria was 27, 928¹. This represents 0.6% of the total Victorian population and 6.1% of the Australian Aboriginal population². The Victorian Aboriginal population is distributed almost evenly between metropolitan and country regions. The Loddon Mallee, North and West Metropolitan, Southern Metropolitan and Hume Regions have the highest Aboriginal populations, whereas Aboriginal people make-up the highest proportion of the total population in the Gippsland, Hume and Loddon Mallee Regions.

The age structure of the Victorian Aboriginal population is considerably younger than that of the non-Aboriginal population. In 2001, 57% of Aboriginal Victorians were under the age of 25 years, compared with 34.1% of the total population. Further, 2.9% of Aboriginal Victorians were over the age of 65 compared with 12.6% of the total Victorian population (Australian Bureau of Statistics 2001a).

^ Top

Early child development and growth

Early childhood covers the period from before birth to 3 years. Health and educational outcomes in later life are greatly influenced by the health, growth and development of children in their first three years of life. A wide range of social, cultural, physical and economic factors influence the health of children.³ The indicators within this period are: perinatal mortality, birth weight of babies, maternal age, immunisation coverage and use of Maternal and Child Health services. For this age group immunisation and use of Maternal and Child Health Service are preventative measures for later health and welfare issues.

• In 2004, the rate of perinatal mortality (stillbirths and deaths before 28 days) per 1000 births to Aboriginal mothers (25.1) was almost double the rate for non-Aboriginal mothers (12.5)⁴. This represents an increase in the perinatal mortality rate among babies born to Aboriginal mothers since 1996-98 (14.8).
• The rate of low birth weight babies (less than 2500g) born to Aboriginal mothers has also increased from 11.0 in 1996 to 17.1 in 2004⁵. These babies are at higher risk of illness and death as infants, and also at higher risk of developing cardiac disease and kidney disease as adults.
• In 2004, 21.3% of Aboriginal mothers who gave birth in Victoria were aged less than 20 years compared to 2.8% of non-Aboriginal mothers⁶.
• Aboriginal families were less likely to use the Maternal and Child Health Service⁷. However, the number of active Aboriginal children (aged 0-2 years) has increased from 961 in 1999/00 to 1279 in 2004/05.
• The number of immunised Aboriginal children aged 12 – 75 months recorded by the Australian Childhood Immunisation Register has increased from 2445 in 2002/03 to 3333 in 2004/05⁸. This is partly due to improved identification of Aboriginal children and increased enrolment in Medicare Australia.

Early school engagement and performance – Kindergarten & School Nursing

The extent to which Aboriginal children begin formal learning at an early age, attend school regularly, and are safe, healthy and supported by their families and communities, all have a bearing on educational outcomes. Research shows that the children most likely to have learning difficulties often have nutritional, hearing, or other health problems.⁹ DHS contributes to early school engagement and performance through its funding of kindergarten places and associated support services.

• In 2004, fewer Aboriginal children enrolled at kindergarten (534) ¹⁰ than the number subsequently attending school the following year (680) ¹¹. However, this represents an increase in the kindergarten participation rate, from 62% in 1999 to 79% in 2004.
• Aboriginal children assessed for hearing problems by the School Nursing Service were more likely to be referred on for follow-up (7.5%) than non-Aboriginal children (6.1%)¹².

Positive childhood and transition to adulthood – Child Protection & Juvenile Justice

The later years of childhood, adolescence and the transition to adulthood are important phases, which build on early childhood development and education. The indicators in this section cover a range of factors with the potential to improve long-term outcomes for Aboriginal people.¹³

• In 2004/05, the rate of child protection substantiations per 1000 Aboriginal children aged 0-18 years (63) was 10 times more than the rate for non-Aboriginal children (6) ¹⁴. Aboriginal children were also more likely to be involved in Protection orders and in out-of home care ¹⁵. Fifty-nine percent of out-of-home care placements complied with the Aboriginal Child Placement Principle (ACPP) at the 30th of June 2005 ¹⁶.
• Aboriginal youth were involved with the juvenile justice system at 11 times the rate of non-Aboriginal males and 23 times the rate of non-Aboriginalfemales ¹⁷.

^ Top

Substance use and misuse

Substance use, and particularly misuse, has the capacity to impact on every aspect of a person’s life. Life expectancy, disability, employment, income, imprisonment, domestic violence and sexual abuse are all areas affected by substance use and misuse. ¹⁸

• Aboriginal people were more likely to smoke and to use alcohol to excess ¹⁹.
• The rate of service use of Alcohol and Drug Community– based services by Aboriginal people was 11 times greater than service use by non-Aboriginal people ²⁰.
• Aboriginal people were more likely to be admitted to hospital for alcohol and drug related conditions ²¹.

Functional and resilient families and communities – Disability, Aged Care, Housing & Health Services

Families and communities are the mainstay of our society. The extent to which either is dysfunctional can have direct impacts on a range of outcomes for Aboriginal people, including life expectancy, education, imprisonment, violence, employment and income. Dysfunctional families and communities can lead to breakdown in relationships and social alienation – significant factors leading to Aboriginal disadvantage. ²²

• Aboriginal people have a higher rate of use of disability services. In 2004/05, the rate per 1000 women aged 65 years and above was 72 for Aboriginal women compared to 22 for non-Aboriginal women ²³. The rate per 1000 men aged 65 years and above was 57 for Aboriginal men compared to 12 for Aboriginal men.
• Aboriginal people are more likely to use certain types of Home and Community Care (HACC) services and less likely to use Aged Care Assessment Services (ACAS) ²⁴
• In 2004/05, 4.6% of Supported Accommodation Assistance Program (SAAP) clients in Victoria were Aboriginal ²⁵. This is a substantial over-representation of Aboriginal Victorians who make up 0.6% of the total Victorian population. This indicates that preventative services are not being used appropriately.
• Aboriginal people are more likely to use public housing ²⁶. The provision of adequate housing is a major factor affecting health. Aboriginal people can access public housing through either the general rental program or the Aboriginal Housing Board of Victoria. Aboriginal households comprise 3% of the total number of households using public housing.

Health

• Aboriginal life expectancy is estimated at 60 years for men and 65 years for women ²⁷, which is approximately 18 years less than respective Victorian non-Aboriginal life expectancy ²⁸. Life expectancy is influenced by a number of factors, including rates of morbidity and access to appropriate services.
• Aboriginal people have generally poorer health than non-Aboriginal people and are more likely to be hospitalised ²⁹. Diabetes, renal failure, cardiovascular diseases and respiratory diseases are the most common chronic conditions in Aboriginal people and among the most common causes of death.
• Aboriginal people are admitted to hospital for diabetes-related illnesses more frequently and at younger ages than non-Aboriginal people.
• The rate of admissions for renal dialysis for Aboriginal women aged 45-64 is 10 times the non-Aboriginal rate. For men of that age it is almost 5 times the non-Aboriginal rate.
• Aboriginal people often develop chronic diseases at an earlier age than non-Aboriginal people. The rate of hospital admissions of Aboriginal people for cardiovascular disease begins to increase steeply by 25-44 years. For non-Aboriginal people the rate increases between 45 and 64 years. The rate of admission for respiratory diseases increases from 45 years, whereas the rate of admission for non-Aboriginal people does not begin to increase until 65 years.

^ Top

About the data

In this publication, data from DHS administrative collections have not been adjusted for Indigenous under-identification. Therefore, data used to calculate rates are likely to be undercounts. For most indicators, cases where Indigenous status was not identified were included in non-Indigenous records.

DHS administrative data collections provide evidence of the poor health of Aboriginal Victorians relative to the general population. However, it is not always possible to report whether the health of Aboriginal Victorians is improving or not. This is partly due to incomplete identification and fluctuations in identification of Aboriginal people in records. It is also partly due to the statistical challenges of reporting on a small population.

The population figures used to calculate population rates presented in this document are ‘estimated resident population at the 30th of June 2001’. The estimated resident population is calculated from the usual residence census count by adjusting for the following factors:

• net undercount,
• cases of unknown Indigenous status, and
• births, deaths and migration between the date of the census count and the reportingdate ³⁰.

1 Australian Bureau of Statistics, 2001, Population distribution, Indigenous Australians 2001, cat. No. 4705.0, ABS, Canberra.

^ Top