A study of health inequality between Indigenous and non-Indigenous Australians

Abstract

The health disadvantage of Indigenous people in Australia has been recognised for a long time. The reasons for this poor health status are considered to be complex and multi-faceted. Socioeconomic status, socio-cultural factors, access to quality healthcare, environmental factors and risky behaviours are considered the major factors affecting Indigenous health. Despite this, very little progress has been made in reducing the health inequality between Indigenous and non-Indigenous Australians.This thesis examines the health inequality between Indigenous and non-Indigenous Australians. First, the thesis investigates the gap in subjective and objective health outcomes between the two populations. The health outcomes include self-assessed health, chronic diseases and injury. Second, it looks at the relative contribution of four factors to the low health status of Indigenous Australians, viz.: demographic, behavioural, socio-economic and cultural. Third, as the Indigenous population is not a homogenous group, the thesis analyses separately the health status of different groups relative to non-Indigenous people. Fourth, the extent of association of each of the four factors to the health outcomes is examined. In addition, similar analyses are undertaken for healthcare utilisation.The thesis finds that only a minor proportion of the gap in health outcomes can be explained by observable demographic, behavioural and socio-economic characteristics. The removal of Indigenous people from their natural families (especially that of relatives) as part of the ‘assimilation policy’ is a major contributing factor to the health status gap between Indigenous and non-Indigenous people. The better socio-economic and behavioural status enjoyed by Indigenous people who experienced removal from their natural families does not improve their health status compared to those who did not experience any removal. Policies to address the trauma and grief associated with past policies of removal are needed if the gap in health status between Indigenous and non-Indigenous Australians is to be closed.