The good will to 'close the gap'

An Indigenous baby boy born in Australia today should not expect to see his 60th birthday. If he is lucky, he might make it to 64. On the other hand, a non-Indigenous baby boy born somewhere in Australia today can expect to live until he is 81, getting to know not only his grand-children but possibly his great grandchildren.

The study released last week by the Australian Institute of Health and Welfare not only confirmed this 17-year gap in life expectancy between Indigenous and non-Indigenous Australians, but disturbingly, found that it was gradually getting wider.

The study found that while Australians overall now have the second-highest life expectancy rates around the world - just behind Japan - health measures for Indigenous Australians remain at levels we would expect to see in developing countries.

It’s sad but true that Indigenous Australians have not shared in the health gains enjoyed by other Australians over the last 20 years. Yet it is inconceivable that a country as wealthy as Australia cannot solve a health crisis affecting less then 3 per cent of its population.

In the past year governments have begun to respond, urged on by the Australian public and community campaigns like “Close the Gap”. Early in Kevin Rudd’s prime ministership we saw the Council of Australian Governments (COAG) commit to closing the life expectancy gap within a generation and halving the mortality gap for Indigenous children under five within a decade.

In an effort to take another step towards improving life expectancy for Indigenous people there are a number of things that COAG can seek to achieve when it meets in Sydney today (July 3).

First, all state governments should sign the Statement of Intent agreed to by Prime Minister Rudd and more recently, Queensland Premier Anna Bligh, to work in partnership with the Indigenous community to “Close the Gap”.

Second, all state governments should agree to follow the Prime Minister’s lead and commit to giving an annual statement to the Parliament on progress made in closing the gap.

Third, all state governments should implement the set of integrated targets - based on many years of reports and evidence - produced by the Human Rights Commission, peak Indigenous and non-Indigenous health bodies, civil societies and government departments at the National Indigenous Health Equality Summit in March.

The good will is certainly there. In 12 months, more than 40 organisations and state and federal governments have committed to working towards Indigenous health equality within a generation.

In addition, more than 115,000 Australians have signed the “Close the Gap” pledge to urge state, federal and territory governments to commit an additional $460 million to annual Indigenous primary health funding, give Aboriginal and Torres Strait Islanders a greater role in the delivery of health services, and address the social environments that perpetuate this inequality.

Last week’s report from the Australian Institute of Health and Welfare should remind us all that the challenge for us now is to translate this public support, political will and historic mood to sustained improvements in Indigenous health, and to close the gap within a generation.

Commensurate funding will be crucial in closing the 17-year life expectancy gap. Achieving Indigenous health equality relies on an enormous investment in primary health care spending for Indigenous Australians in essential medicine, immunisation, maternal and child health and the prevention and control of disease.

Crucial to closing the gap is investment in Aboriginal community-controlled health services such as the Victorian Aboriginal Health Service in Fitzroy, which last week celebrated its 35th birthday.

It has an annually elected Aboriginal board, and a majority of Aboriginal health staff and management. It is “close the gap” in action, consistently achieving a 91 per cent child immunisation rate, compared to rates of less than 50 per cent for Aboriginal children elsewhere in Victoria.

Meanwhile, a 2007 report by the Australian Medical Association uncovers evidence of inherent discrimination in our health system. Racism is just one of the social determinants of Indigenous health. Others include housing, water and sanitation and successful Aboriginal and Torres Strait Islander health programs have been those that have recognised and addressed the broad range of these determinants.

With COAG meeting today in Sydney, let’s maintain pressure on state, federal and territory governments to release details of their commitments with timeframes, targets, and priorities to address the Aboriginal health crisis. But let’s also look to ourselves and assess how we can change our own behaviour to help create a social environment that is conducive to achieving Aboriginal health outcomes.

Let us be the generation that closed the gap and finally achieved Indigenous health equality.