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Cut jail time to build on Indigenous health gains

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Soaring Indigenous imprisonment rates and a stubbornly wide life expectancy gap underline calls for the Federal Government to fully fund the National Aboriginal and Torres Strait Islander Health Plan.

AMA President Professor Brian Owler said the latest update on Indigenous health and welfare from the Close the Gap Steering Committee was “a mixed bag”, showing improvement on measures such as child mortality and year 12 attainment, but weak gains in others.

The report found the target to halve the gap in child mortality by 2018 was on track, supported by a lift in immunisation rates that has seen more Indigenous children vaccinated by age five compared with their non-Indigenous counterparts, and Indigenous mortality rates, particularly from heart disease and stroke, are declining.

But the gap in life expectancy is not narrowing fast enough to close by the Council of Australian Government’s 2031 target.

The Close the Gap report shows that between 2005 and 2012, the life expectancy of Indigenous men increased by 1.6 years to 69.1 years, and for Indigenous women 0.6 of a year to 73.7 years (the life expectancy of non-Indigenous men in 2012 was 79.7 year and women, 83.1 years).

But the report’s authors cautioned that the improvements were within the margin of error “and could, in fact, be non-existent”.

Indigenous life expectancy is improving at an annual rate of 0.32 years for men and 0.12 years for women, but the Steering Committee said this would have to increase to between 0.6 and 0.8 years annually to reach the 2030 target.

Driving much of the improvement has been a 40 per cent fall in deaths from heart attacks and strokes, and fatal respiratory illnesses have declined by 27 per cent.

Despite this, heart attacks a strokes remain a major killer, accounting for a quarter of all Indigenous deaths between 2008 and 2012, while suicide was the leading cause of death due to external causes.

“It is disappointing that the target to close the gap in life expectancy by 2031 is not on track,” Professor Owler said. “This is a clear signal that we have to put politics aside and work together to reach this important milestone. Above all, we need consistent funding and support from all governments.”

In his report on Closing the Gap, Prime Minister Malcolm Turnbull agreed that a more concerted effort was needed.

“As a nation, we are a work in progress, and closing the substantial gaps in outcomes between Aboriginal and Torres Strait Islander people and other Australians is one of our most important tasks,” Mr Turnbull said. “There has been encouraging progress…but it is undeniable that progress…has been variable.”

Professor Owler said that to make improved gains, the Federal Government should reverse Budget cuts to programs like the Indigenous Advancement Strategy and the Indigenous Australian Health Program, and commit to genuine engagement with Aboriginal community controlled health services.

Nonetheless, a rapid narrowing of the health gap for infants and young children gives hope that eventually it will narrow for adults as well.

Though the infant mortality rate for Indigenous infants is 1.7 times that of other Australians, it declined 64 per cent between 1998 and 2012, making the gap 83 per cent narrower.

Close the Gap Campaign Co-Chair Dr Jackie Huggins said the long term impact of such improvements were yet to be seen and would take time to measure. The report advised no measurable improvements should be expected before 2018.

Furthermore, Dr Huggins said, “this should not be cause for complacency, because the overall health of Aboriginal and Torres Strait Islander peoples still lags behind the rest of the nation”.

The Campaign backed the AMA in calling for governments to reduce Indigenous incarceration rates.

It warned the nation was on track to have a record 10,000 Indigenous people behind bars this year, which is described as “a grim milestone”.

An AMA report highlighted that imprisonment exacerbated serious health problems and Indigenous incarceration rates needed to be reduced if the country was to close the health gap.

Adrian Rollins