Introduction to Closing the Gap Program
The Australian population, according to historical data comprises of aboriginal and Torres Strait Islander people as a part of its indigenous community and their cultural strength and resilience played a significant role in addressing the trauma inflicted upon Australia’s First Peoples past policy. The Closing Gap Program has been functioning from 2008, its target date is 2030, and it has been seen that over the years, the gap has reduced and this was successful due to several efforts on the part of the government (Chan, 2014). The indigenous people are living long and the death rates are going down. The program aims at improving the situation of inequalities in the sectors of health, employment, and education (Boyle, Zhang, & Chan, 2014). This essay addresses the health and life expectancy differences or inequalities between indigenous and non-indigenous Australians over the last 10 years. This paper will be analysing the program to deal with the issue of reducing indigenous inequality.
The strategy, Closing the Gap was developed in March 2008 by the Australian government to build a compact between the Australian government and the Aboriginal and Torres Strait Islander people and attempts to bridge the inequality in health. The program found that population and growth outcomes results from factors like racism, housing quality and access to healthcare and these factors have to be addressed to bring about improvements in health (Altman, Buchanan & Biddle, 2006). The close the gap strategy has incorporated the Federal Government-supported United Nations Declaration of the Rights of Indigenous People for their right to health. An effective heath plan was not in place and there needs to be a national plan to take care of housing and infrastructure along with sufficient resources. The strategy also focuses on child and maternal health and takes care of chronic diseases and risks. It aims at building primary health service infrastructure for the indigenous people. This program was abandoned after the fifth year due to lack of architecture to support the Closing Gap Strategy. A refreshed strategy is required to be formulated which would provide equal opportunity to healthcare services and goods to both the indigenous and non-indigenous Australians. Along with this, determinants of inequality like racism, education and income to name a few, must also be addressed. Just like spending on the older population more than the young population seems normal, spending more on the Aboriginal and Torres Strait population’s healthcare should also come across as normal because according to data from the Australian Government Department of the Prime Minister and Cabinet, there is 2.3 times higher risk for them to face diseases. Despite this, the expenditure on per indigenous individual was $1.38 and per non-indigenous person was $1 in 2013-2014 when the difference should have been much greater (Commonwealth of Australia, 2018). So for most of the duration of the program duration, the expenditure from the Australian government was not at par with the complex health needs. The investments made have been in the wrong areas focusing more on the tertiary sectors instead of the primary sector of health. The investment has sometimes been focused at the mainstream population instead of the indigenous and sometimes a huge part has gone out to meet government administrative costs. The non-indigenous part of the population depend on private healthcare services along with the public healthcare providers to meet their health needs which makes the situation of the indigenous population as a market failure. Private sources cannot make up for this shortage and the Australian government has to adopt market intervention policy with increased expenditure to as to bridge the gap in the mortality rates and life expectancy rates between the two groups.
Analysis of Closing the Gap Program
According to the latest data from the Australian Institute of Health and Welfare, the target to halve the child mortality rate gap by 2018 is on track where the indigenous child mortality rate has declined by 35% and the gap has narrowed down by 32%. The persistent improvements in maternal and child health paint a successful future scenario. However, the target to close the gap in life expectancy by 2018 is not on track where there has only been a slight decline in the gap between the years 2005- 5007 and 2010 – 2012. The reduction was 0.8 years in men and 0.1 years in women with the fall in the long-term mortality rate by only 14%. Data released by the Productivity Commission in 2017 saw that the direct expenditure had dropped to 18% from 22.5%
Figure 1: Average Life Expectancy at Birth for selected OECD countries, 2015
Source: Australian Government Department of the Prime Minister and Cabinet
The approach to achieve the said targets must be more holistic taking into account the cultural, emotional, social and economic contexts of the indigenous population and their history associated with colonisation. They should be made more involved in the different stages of development and delivery of the program and a collaborative relationship should be built between the government and other agencies involved in the delivery of the said goals to acknowledge the interrelatedness of the key economic indicators (Shepherd, et al., 2014).
Figure 2: Distribution of indigenous and non-indigenous Deaths, 2011-2015
Source: Australian Institute of Health and Welfare
Immunisation plays a significant role in the reduction of mortality and morbidity rates and the introduction of vaccines has saved some 78000 lives and has reduced the prevalence of avoidable diseases by 99%. This has effectively reduced the disparities between the indigenous and the non-indigenous. The target to be achieved is set at 95% coverage of immunisation of children has been set by the Commonwealth Chief Medical Officer and Australia has, over the past 10 years improved at achieving this goal. Intervention in the first 3 years of life has had great impacts on the life expectancy and health outcomes.
Pros and cons of Closing the Gap Program
Since 1998 to 2016 indigenous child mortality rate has reduced to 146 deaths per 100000 to from 217 deaths per 100000 (Biddle, 2014). The progress has slowed with the rate of child mortality among the indigenous population around 11.5%. In the span between 2012 – 2016, almost 82% of indigenous child deaths were infants and this rate of death of infants was double the rate of non-indigenous infant death rate (Pace, 2015). More than half of these deaths were due to perinatal conditions. The decline in child death among indigenous infants has been around 10% from 2008 (Marshall, 2018).
On the business perspective, it has been noticed that a lot of indigenous Australians getting into business is growing by 30% from 2011 – 2016 while there has been a 1% increase in the non-indigenous Australians (Alford & Muir, 2004). This has been possible due to the Indigenous Procurement Policy introduced in 2015, along with the Commonwealth Government, for its demand for services by the indigenous businesses. The Australian government to enhance employment and business capability has also provided infrastructural support.
In conclusion, the Closing the Gap Strategy had a lot of plus points like addressing to chronic diseases, child and maternal health and other recognized successes which should be continued to be supported. However, the issue of the lack of continuity and the absence of a set of programs to address the causes behind the health inequality between the mainstream Australians and the Aboriginal and Torres Strait Islanders is one of the major criticisms it faces. Efforts should be taken to go beyond the goals to just address the inequalities in education, employment and health between the mainstream Australians and the indigenous people, to a point where they can choose to pursue the life that they value for.
Reference:
Aihw.gov.au, (2018). Home – Australian Institute of Health and Welfare. Retrieved from https://www.aihw.gov.au/
Alford, K., & Muir, J. (2004). Dealing with unfinished Indigenous business: the need for historical reflection. Australian Journal of Public Administration, 63(4), 101-107.
Altman, J., Buchanan, G., & Biddle, N. (2006). Measuring the’real’Indigenous economy in remote Australia using NATSISS 2002. Australian Journal of Labour Economics, 9(1), 17.
Biddle, N. (2014). Measuring and analysing the wellbeing of Australia’s Indigenous population. Social indicators research, 116(3), 713-729.
Boyle, C., Zhang, H., & Chan, P. W. K. (2014). Closing the gap. In Equality in Education (pp. 217-222). SensePublishers, Rotterdam.
Chan, W. L. (2014). Closing the gap. Equality in Education: Fairness and Inclusion, 217.
Commonwealth of Australia. (2018). Closing the Gap: Prime Minister’s Report 2018.
Dudgeon, P., Walker, R., Scrine, C., Shepherd, C., Calma, T., & Ring, I. (2014). Closing the gap.
Marshall, L. (2018). Closing the gap. Impact, 2018(1), 84-85.
Pace, A. K. (2015). Closing the Gap. Serials Review, 41(1), 3-7.
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