Overview of the Closing the Gap Strategy
The social justice report of 2005 released by professor Tom Calma who was by then serving asAboriginal and Torres Strait Islander Social Justice Commissioner led to the introduction of the Closing the Gap strategy .In the report, the Social justice commissioner called for a commitment by the Australian Government into the realization of life expectancy and health equality for Torres Strait Islanders peoples and the Aboriginals in a period of 25 years (Australian Indigenous HealthInfoNet,2015).
Since its introduction the strategy has been of major significance to the health of the Aboriginals and Torres Strait Islander Peoples. On an average Torres Strait Islander Peoples and the Aboriginals have a longer life expectancy than before. The main causes of death among these groups such as stroke and heart attack are on the decline. Among the indigenous males, their life expectancy has increased by 0.32 years since the period 2005/2007 while that of the females has increased by 0.12 years. These statistics are expected to keep rising.
The strategy has also led to a decline in child mortality rates among the Indigenous populations especially for deaths associated with chromosomal and congenital conditions as well as other conditions characteristic of the prenatal period. The period between 2006 and 2015 has recorded a major decline in major causes of child mortality among the Aboriginal and Torres Strait Islanders. Statistics from 1998- 2015 shows a significant decline in Infant mortality rate by 66 percent. A decline of 18% was also recorded in the period between 2008 and 2015.Data from 2016 analysis has shown progress towards the target. This is an improvement from the 2015 Statistics which had indicated that the track was not on track (Australian Human Right Commission, 2017).
An improvement in the health quality and life expectancy among the two groups has also enabled them to engage more in business as demonstrated by a 12.5 percent growth rate among Indigenous businesses. This is deemed the highest compared to other sectors making up the Australian Economy .In addition, the strategy has also led to an improvement in numeracy and literacy among the two indigenous groups besides improving the number of enrollments of Torres Strait Islanders and Aboriginal Children in early childhood education to over 14,700. In addition it has increased the number of Aboriginal and Torres Strait Islander children staying in school throughout the year. Data from 2015 shows an 87% ECE enrollment rate in among indigenous children as compared to 98 enrollment for non-Indigenous children. In addition, the attendance rate for the enrolled Indigenous children was found to be 92% compared to the 96% attendance rate among the non-indigenous children(Australian Human Right Commission, 2017).
With an improvement in education attainment, it is expected that the strategy will continue to open greater economic opportunities for the Aboriginal and Torres Strait Islander hence improving their lives. Data from 2016 indicates that the early childhood education target is on track (Australian Human Right Commission, 2017).
Social determinants of heath refer to the social and economic conditions in which individuals are born, work, live, grow and age .The main determinants of these conditions are the distribution of resources, power and money. These circumstances are responsible for differences in group and individual’s health status. Social determinants of health associated with the socioeconomic position are used to explain the variations of health outcomes among the indigenous Populations as well as explaining the gaps witnessed in the health status of Non-Indigenous and Indigenous Australians. As a reason for these disparities the well-off have better health and live longer as compared to individuals of lower incomes. The lower the socioeconomic position the worse the heath status and vice versa, research has shown that an understanding of social determinants of health is of major importance in understanding and finding solutions to the health gap between the Indigenous and Non-indigenous Australians (Zhao, Wright, Begg & Guthridge,2013).
Impact of the Strategy on Aboriginal and Torres Strait Islander Health
An empowered community Initiative is collaboration between governments and indigenous communities in setting up priorities effectively apply for to fund and improve services at the community level. In an empowered community Initiative the culture of indigenous communities as well as their participation is highly prioritized. Empowered community initiative is aimed at empowering communities, individuals and families to better their lives. Empowered community initiative works on the assumption that communities, individuals and families are better placed to understand what their priorities are as well as what works and what doesn’t work for them. The initiative seeks to institute the necessary changes among the community by prioritizing the input of communities by ensuring that they make as many decisions as possible. It also seeks to ensure that communities influence decisions touching on their health and overall well being (Altman & Taylor,2018). Empowered community initiative seeks to build decision making abilities and capacities to enable them to take part in decisions making processes confidently.
Among the Indigenous Australian communities, the initiative seeks to establish a balanced and authentic collaboration between Corporate Australia, the Government and indigenous Organizations. It is a transformational reform centered on empowering communities through empowering individuals. The initiative is led by indigenous people due to the fact that because it is them whose lives are affected they should have a bigger say and influence over decisions touching on their well being (Ilton, Walsh, Brown, Tideman, Zeitz & Wilson,2014). Closing the Gap strategy was introduced with the aim of improving the lives of Torres Strait Islanders and the Aboriginal (Australian Indigenous HealthInfoNet, 2015).
The Introduction of the strategy was followed by setting up of targets by the Council of Australian Government s (COAG) in 2008.These targets were aimed at bridging the gap between health outcomes of the non indigenous and non-indigenous Australians (National Congress of Australia’s First Peoples,2017). The targets set by the Council include closing the gap in life expectancy by 2030; reductuion of mortality rates among the indigenous Children below five years within a decade; ensuring a 95% enrolment rate among the indigenous children aged four in ECE by 2018; reduction of the numeracy, writing and literacy gap among indigenous children by 2018 and bridging the gap in employment outcomes between the indigenous and non-indigenous by half by 2018 (Australian Human Right Commission, 2017).
The closing the gap initiative has the potential of impacting the Social determinants of health for the Torres strait Islanders and The Aboriginals .it has the potential of reducing the life expectancy gap between the Indigenous Australians and the non-Indigenous Australians. Before the initiative was rolled out, a huge disparity existed in the life expectancy gap between these groups (Durey & Thompson, 2012). Successful implementation of the initiative also has the potential of reducing the mortality rates among the Aboriginal’s and Torres Strait Islanders. Statistics have shown the life expectancy of the Indigenous Australians born between the period 2010 and 2012 to be 10.6 years lower compared to that of the Non-Indigenous Australians (Parker & Milroy, 2014). One potential impact of this strategy is therefore bridging this gap. The health Inequality between the Indigenous and non indigenous Australians is a known fact. Substantial inequalities have been noted in the areas of mental health, infant health, chronic and communicable diseases. An additional potential impact of this strategy will be enhancing the equality in the health status of the Indigenous and non indigenous Australians (Markwick, Ansari, Sullivan,Parsons & McNeil, 2014).
Potential Impact of the Initiative on Social Determinants of Health
A huge proportion of the Indigenous Australian’s Students achieving Numeracy and literacy benchmarks has remained considerably lower compared to the Non-Indigenous Australians (Behrendt, Larkin,Griew & Kelly, 2012). This has also been the case with the number of students above or at the Minimum reading and Numeracy standards, although this has recorded major improvement between 2008 and 2014.The initiative has the potential of bridging this gap in numeracy and literacy among the Torres Strait Islanders and The Aboriginals. By empowering the individual’s through education and other strategies, the initiative will also enhance the economic participation of the two groups by bridging the gap in employment and capacitating them to initiate and run businesses.
Recent statistics show that three of the targets set in the closing the gap initiative are on the on the path of their achievement. These include the target to reduce child mortality gap which has declined by 35%.The target to increase the number of enrollments in early childhood education for all indigenous children aged five is also on the right course(Australian Human Right Commission, 2017). In 2016 alone the rate of enrollment was at 91%.This is also the case with the target of closing the gap in school attendance (Australian Human Right Commission,2017).2017 statistics showed an 83.2% percent enrollment rate which was 9.8% lower compared to that of the students belonging to Non-Indigenous Australians. This is therefore a major improvement. The near achievement of these targets shows that successful implementation of the closing the gap strategy can have a major positive impact on the Torres Strait Islander and Aboriginal’s social determinants of health (Australian Institute of Health and Welfare,2017).
References
Altman, J., & Taylor, J. (2018). The 1994 National Aboriginal and Torres Strait Islander Survey: Findings and Future Prospects. Canberra, ACT: Centre for Aboriginal Economic Policy Research, Research School of Social Sciences, College of Arts & Social Sciences, The Australian National University.
Australian Human Right Commission,. (2017). Social determinants and the health of Indigenous peoples in Australia – a human rights based approach | Australian Human Rights Commission. Retrieved from https://www.humanrights.gov.au/news/speeches/social-determinants-and-health-indigenous-peoples-australia-human-rights-based
Australian Indigenous HealthInfoNet. (2015). what is closing the gap? Retrieved from https://healthinfonet.ecu.edu.au/learn/health-system/closing-the-gap/gap
Australian Human Right Commission,. (2017). Close the Gap – Progress & Priorities report 2017 | Australian Human Rights Commission. Retrieved from https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/publications/close-gap-progress-0
Australian Institute of Health and Welfare,. (2017). Indigenous Australians Overview – Australian Institute of Health and Welfare. Retrieved from https://www.aihw.gov.au/reports-statistics/population-groups/indigenous-australians/overview
Behrendt, L. Y., Larkin, S., Griew, R., & Kelly, P. (2012). Review of higher education access and outcomes for Aboriginal and Torres Strait Islander people.
Durey, A., & Thompson, S. C. (2012). Reducing the health disparities of Indigenous Australians: time to change focus. BMC health services research, 12(1), 151.
Ilton, M. K., Walsh, W. F., Brown, A. D. H., Tideman, P. A., Zeitz, C. J., & Wilson, J. (2014). A framework for overcoming disparities in the management of acute coronary syndromes in the Australian Aboriginal and Torres Strait Islander population. A consensus statement from the National Heart Foundation of Australia. The Medical journal of Australia, 200(11), 639-643.
Markwick, A., Ansari, Z., Sullivan, M., Parsons, L., & McNeil, J. (2014). Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria. International journal for equity in health, 13(1), 91.
National Congress of Australia’s First Peoples,. (2017). Redfern Statement | National Congress of Australia’s First Peoples. Retrieved from https://nationalcongress.com.au/redfern-statement/
Parker, R., & Milroy, H. (2014). Aboriginal and Torres Strait Islander mental health: an overview. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd ed. Canberra: Department of The Prime Minister and Cabinet, 25-38.
Zhao, Y., Wright, J., Begg, S., & Guthridge, S. (2013). Decomposing Indigenous life expectancy gap by risk factors: a life table analysis. Population health metrics, 11(1), 1.
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