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Cut Indigenous imprisonment to help close health gap

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Sky-high rates of Indigenous incarceration need to be dramatically reduced if the nation is to close the health gap blighting the lives of Aboriginal and Torres Strait Islander people, according to AMA President Professor Brian Owler.

Launching the AMA’s Indigenous Health Report Card 2015, Professor Owler said being imprisoned had devastating lifelong effects on health, significantly contributing to chronic disease and reduced life expectancy.

“Our Report Card recognises that shorter life expectancy and poorer overall health for Indigenous Australians is most definitely linked to prison and incarceration,” the AMA President said.

Aboriginal and Torres Strait Islander people are hugely over-represented in the nation’s prisons – almost 30 per cent of all sentenced prisoners are Indigenous.

While some progress has been made in recent years in improving infant and maternal health, the AMA President said that imprisonment rates were rising, and the country was set to reach a “grim milestone” next July when, on current trends, the number of Indigenous people in custody will reach 10,000, including 1000 women.

In its Report Card, launched by Rural Health Minister Fiona Nash, the AMA has urged Federal, State and Territory governments to set a national target for cutting rates of Indigenous imprisonment.

The call has come just days after disturbing details of the death of a young Aboriginal woman who was being held in police custody for failing to pay $3622 of fines.

A West Australian coronial inquest has been told the 22-year-old woman, known as Miss Dhu for cultural reasons, was in a violent relationship and using drugs at the time of her arrest last year. While in the South Hedland Police Station she collapsed after complaining of pain and difficulty breathing.

It was later found she had several broken ribs following an attack by her partner, and died from a lethal combination of pneumonia and septicaemia.

Miss Dhu’s death has fuelled calls for WA to overhaul laws regarding the imprisonment of fine defaulters.

But the AMA has said a much broader approach needs to be taken.

Indigenous adults are 13 times more likely to be jailed than other Australians, and among 10 to 17 year-olds the rate jumps to 17 times.

Professor Owler said it was possible to isolate the health issues that led to so many Aboriginal and Torres Strait Islander people landing in prison, and they included mental health conditions, alcohol and drug use, substance abuse disorders and cognitive disabilities.

He said the “imprisonment gap” was symptomatic of the health gap, and the high rates of imprisonment of Aboriginal and Torres Strait Islander people, and the resultant health problems, needed to be treated as a priority issue.

In particular, he said, the health issues identified as being the most significant drivers of Indigenous imprisonment “must be targeted as a part of an integrated effort to reduce Indigenous imprisonment rates”.

Professor Owler said the evidence showed that Aboriginal and Torres Strait Islander people continued to be let down by both the health and justice systems, and firm and effective action was required.

“It is not credible to suggest that Australia, one of the world’s wealthiest nations, cannot solve a health and justice crisis affecting 3 per cent of it citizens,” he said.

Reconciliation Australia Co-Chair Professor Tom Calma said the AMA’s “very substantial” Report Card was latest in a long list of reports identifying the need for action, and urged governments to “get on with it”.

Professor Calma said there had been “some really good outcomes” from recent initiatives to improve prisoner health, particularly moves in many states to ban smoking in jails.

But he said more needed to be done to tackle recidivism, citing figures showing 50 per cent of Indigenous prisoners reoffended.

The Indigenous leader said that this was not surprising because often people getting out of prison returned to the same situation that got them into trouble in the first place, and urged action to tackle the causes of offending in the place, such as alcohol and drug abuse.

Among its recommendations, the AMA has called for funds freed up from reduced rates of Indigenous incarceration to be reinvested in diversion programs; for governments to support the expansion of chronic health and prevention programs by Aboriginal Community Controlled Health Organisations; for such organisations to work in partnership with prison health authorities to improve health and reduce imprisonment rates; and to directly employ Indigenous health workers in prison health services.

Adrian Rollins

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