More than a third of the burden of disease experienced by Indigenous Australians could be prevented, with tobacco and alcohol use, high body mass, physical inactivity, high blood pressure and diet contributing to their illnesses, data released by the Australian Institute and Health and Welfare shows.
The institute examined the number of years of healthy life lost through living with an illness or injury, described as the non-fatal burden, and the number of years of life lost through dying prematurely from an illness or injury, described as the fatal burden.
Using 2011 data from the Northern Territory, Western Australia, New South Wales and Queensland, it found that chronic diseases such as diabetes and heart disease caused 64% of the total disease burden among Indigenous Australians.
Mental and substance use disorders were responsible for 19% of this burden followed by injuries including self-harm (15%), cardiovascular diseases (12%), cancer (9%) and respiratory diseases (8%).
Assoc Prof Aunty Kerrie Doyle from RMIT University’s school of health and biomedical sciences said it was “disturbing” that the third most common cause of deathfor Indigenous people were injuries, such as through suicide, violence including domestic violence, and alcohol poisoning.
“We must address this, it’s just so sad,” she said. “We need to address mental health and social determinants of health, certainly through looking at things like social inclusion, community inclusion.
“We need to think about how we can foster resilience in our Indigenous youth, and we need more mental health clinicians and, specifically, Indigenous mental health clinicians who are trained to the same standards as everyone else.”
While the gap in disease burden between Indigenous and non-Indigenous Australians remained significant, Friday’s report found that between 2003 and 2011 the total burden of disease in the Indigenous population fell by 5%, with an 11% reduction in the fatal burden.
Infant death rates have fallen, which Doyle said was thanks to a reduction in maternal smoking rates, better access to healthcare and effective maternal education programs.
But there was a 4% increase in the non-fatal burden over the same period, suggesting a shift from dying prematurely to living longer with disease.
Prof Ian Anderson, the foundation chair in Indigenous health at the University of Melbourne, said the report was “critical” because it highlighted where governments needed to invest. “Until 2008 there hadn’t been a significant investment in Australia in anti-smoking programs for Indigenous Australians at a national level,” he said.
“Based on an earlier analysis of burden of diseases it was obvious smoking was a major factor in diseases, and as a result the investment was made.”
The Heart Foundation’s spokesman for Aboriginal and Torres Strait Islander heart health, Simon Dixon, said the report highlighted that many barriers existed in regard to service access and delivery of best-practice care. More than one in four Aboriginal and Torres Strait Islander people had problems accessing health services, he said.
“For historical, geographical and cultural reasons, healthcare services remain under-utilised by Aboriginal and Torres Strait Islander peoples,” Dixon said. “As a result, poorer health and lower quality of life become the ‘norm’ until a critical event like a heart attack happens, which, unfortunately, is too late for many.
“It has been estimated that if Aboriginal and Torres Strait Islander peoples achieved the same level of cardiovascular health as non-Indigenous Australians, this mortality gap could be closed by 6.5 years.”
The NT and WA had higher rates of Indigenous burden of disease than NSW and Queensland, the report also found.
Indigenous health: a third of disease suffered is preventable, says study
