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Indigenous health: sorry is not enough

By Harry Throssell - posted Friday, 23 March 2007

Social determinants of Indigenous health is a collection of papers which shows once and for all that severe ill-health among Indigenous Australians has its basis in loss of culture, racial prejudice, social inequality, poverty.

It is not an ideological statement - although there are important political implications - but a comprehensive, compelling account of serious health problems told by 18 Indigenous and other scholars in the medical and social sciences.

Indigenous Australians have lived on this continent for more than 50,000 years but have had difficulties surviving the past 200 years. Why? The average lifespan for all Australians is 80 years but for Indigenous folk only 60 years (shorter than Indigenous life-spans in New Zealand, USA and Canada). Why? Australia is the world’s third richest country but many Indigenous people struggle with serious poverty and associated diseases. Why? An adequate living standard is a principle of international human rights agreements but has not become part of Australian law. Why?


The 13 essays are based on a series of courses in Darwin in 2004-5, and with 50 pages of references, chapter summaries and questions for discussion, they are ideal for further study up to the highest academic levels. It is much more than a study guide, however. It has serious messages for social justice and should be compulsory reading for all members of parliament: state, federal, and local.

Indigenous leader Lowitja O’Donoghue puts the issues in a nutshell: “When considering health, you need a model that … acknowledges a history of oppression and dispossession, and a history of systematic racism”. She refers to the Bringing Them Home report, racism that is “still deeply embedded in the structure of our society”, felt powerfully in economic disadvantage, young people alienated from family and community, the lack of Aboriginal representation at all levels of government.

Indigenous health “has been aptly described as Third World health in a First World nation”, and she quotes the National Aboriginal Health Strategy: “health encompasses the social, emotional, spiritual and cultural well-being of the whole community.”

The Universal Declaration Of Human Rights states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control”.

This principle was also the basis of other International Covenants and Conventions. However, unless such treaties are incorporated into Australian law by domestic legislation they are not enforceable in this country. And Federal Governments have chosen not to incorporate them.

Indeed, the United Nations Committee on Economic, Social and Cultural Rights placed specific obligations on the Australian government and required it to “refrain from interfering … with the enjoyment of the right to health … and adopt appropriate … measures towards the full realisation of the right to health”.


But there remains no statute which imposes a responsibility on Australian government to ensure Indigenous people have access to the social determinants of good health. Indeed, by dismantling the Aboriginal and Torres Strait Islander Commission and limiting the power of the Human Rights and Equal Opportunity Commission, the current government “has largely disabled any formal and independent criticism of its approaches to human rights and the Indigenous population”.

It is argued the forced separation of children from their natural families as described in the Bringing Them Home report had human rights implications which could have “breached international conventions to which Australia was a signatory”. But in one case the High Court held that as the policy of the time cited that the removal of Aboriginal children from their families was “in their own best interests”, the necessary intention to harm them was not established.

One author concludes pessimistically, “it is highly unlikely [the Australian government] will choose to consider itself bound … by the human rights implications of its public health and social policy”.

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Social determinants of Indigenous health edited by Bronwyn Carson, Terry Dunbar, Richard D. Chenhall and Ross Bailie. Allen and Unwin, 2007.

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About the Author

Harry Throssell originally trained in social work in UK, taught at the University of Queensland for a decade in the 1960s and 70s, and since then has worked as a journalist. His blog Journospeak, can be found here.

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