No excuses

Australian Indigenous people in general have life-spans on a par with some of the poorest countries in the world.

The average age of death for Queensland’s original peoples is 56 years, according to the 2006 Edition of Queensland’s Aboriginal and Torres Strait Islander Population, compared with the whole community’s average of 79 years (54 years for males compared with 76 and 58 years for females compared with 82).

The same general pattern has been seen across the country for a long time. The 2004 Senate Report on Poverty noted “life expectancy for Indigenous people is approximately 20 years less than … other Australians”. An Australian Bureau of Statistics report of 2005 says figures in this area are not entirely reliable, but their median lifespan for Indigenous males throughout the country was 59 compared with a non-Indigenous age of 77 years, the figure for women 65 and 83 years respectively.

In any case the difference is considerable, at least 18 years.

“Life expectancy” does not mean all members of a population live to that age. The Queensland report refers to it as a median, or average, of all the ages at which death occurs. Indigenous communities show a much higher infant and childhood death rate than non-Indigenous communities, so these fatalities, as well as those in old age, whatever the cause, contribute to the average life expectancy. This figure therefore reflects the general state of health, and also the state of the health services in the community.

The health and poverty profile of Australia’s Indigenous people is usually obscured from global attention because they are a very small proportion, less than 3 per cent, of the country’s total population. But a different picture becomes clear on examination of United Nations Human Development annual reports.

In the latest of these the Human Development league table shows Australia ranking number three, meaning it has, on the whole, the third highest standard of living in the world, measured by the Human Development Index. This includes a Long and Healthy Life, Knowledge, and a Decent Standard of Living, collections of many other research findings. There are 63 nations in the High Human Development bracket, the world’s richest countries, the first ten of them listed here.

The table shows how long, on average, a citizen in these countries can expect to live, and his or her comparative average “income”, or Gross Domestic Product per head, in US dollars.

In contrast, countries with average life expectancy figures similar to that of Australia’s Indigenous population, say between 50 and 65 years, are listed below. Again, the figure in the first column is the country’s position in the global league table of living standards, while in the fourth column, again, is the country’s average income, to compare, for instance, with Australia’s overall average of US$30,331 per head.

Countries with the HDI rank of 122 (Tajikistan) to 143 (Madagascar) are classed as Medium Human Development Countries, while those ranked 147 (Togo) to 163 (Benin) are Low Human Development Countries, along with a further 14 countries even worse off, down to the last, number 177.

The vast difference in both life expectancy and “income” per head is very clear.

The category called Developing Countries, third behind High Development and Medium Development countries, have an average life expectancy of 65 years, nine years more than Aborigines and Islanders in Queensland, while Least Developed Countries show 52 years. Average life expectancy in South Asia is 64 years, in Sub-Saharan Africa 46 years. The average for all Low Income Countries, 59 years, is on a par with Australia’s Indigenous figure.

It is impossible to escape the conclusion the average duration of life for Australia’s Indigenous peoples is comparable to what is sometimes referred to as the Third World. And yet Aborigines and Islanders live in a country third on the rich list.

It is also impossible to avoid the conclusion it is poverty that is a prime cause of the high rates of sickness and other causes of death in Australia’s Indigenous communities. A conclusion well understood by many Australian doctors and the Australian Medical Association. But there was not one word about Indigenous health in the Federal Treasurer’s 2006 Budget speech.

Paul Farmer, Professor of Medicine at Harvard University, has run clinics for AIDS and other infectious diseases in USA, Haiti and Peru. In his book Infections and Inequalities he emphasised infectious diseases owe their existence and persistence as human killers most of all to poverty, which explained their prevalence in certain countries and communities.

“Studies compiled from the twelfth century onward”, he wrote, “show that the poor, quite simply, are sicker than the non-poor and that this is true in both rich and poor countries”.

Infectious diseases remain the world’s single most common cause of death and although the majority of deaths occur in the developing world, infectious diseases remain a major killer of America’s poor.

“Poverty and racism increase the likelihood of dire outcomes among the sick by restricting access to effective therapy or rendering it less effective if patients are malnourished or addicted”. Poverty also decreases the ability of patients to comply with lengthy treatment regimes, while “a growing body of data … reveals that income distribution is related to national mortality rates”.

The United Nations Human Development Report 2006 concludes: “The increasingly visible divides that separate the haves and the have-nots in rich countries have become a focal point for discontent. One of the central human development challenges in the decades ahead is to diminish the tolerance for extreme inequalities that have characterised globalisation since the early 1990s and to ensure that the rising tide of prosperity extends opportunities for the many, and not just the privileged few.”

Australia has no excuse; it is the third richest country in the world.