AT2: Issues Analysis

How do Aboriginal and Torres Strait Islander community’s remote location subject
them to disadvantage in health and contribute to their susceptibility to diseases and
high mortality rates?

Introduction: Briefly addressing the Aforementioned

There is a significant gap in the mental, physical, emotional and social health status of

Aboriginal and Torres Strait Islander (ATSI) people compared to non-indigenous Australians.

In statistical terms, ATSI people are said to live an approximate difference of 10 years shorter

than non-indigenous Australians, a truly startling figure (Australian Institute of Health and

Welfare, 2019). The weighty dissimilarity in health of ATSI people in comparison to non-

indigenous Australians is due to multiple influential factors commonly deriving from

location. This assignment discusses how remote location subjects ATSI communities to a

significant health disadvantage and increased mortality rate in comparison to non-indigenous

Australian’s.

This paper will explore in detail the repercussions of living in remote locations This

assignment will also discuss how the census helps determine the population, as well as the

results and how they affect the governments decisions to start certain organisations and

prompt funding. For Indigenous Australian’s, their remote location often results in inadequate

access to fresh fruit and vegetables and a lack of or restricted education. These limitations

can lead to higher susceptibility to certain diseases and mortality rates and are deemed as

vitalities as they influence one’s capacity to develop. Government and non-government

organisation initiatives and efforts will be explored in detail and suggestions for further

education and organisations will be put forward.

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Remote Location

Remote location is defined as a geographical location more than 300km away from any large

urban city or town. The relationship of remoteness and health is predominantly important to

Indigenous Australians as they are more likely to live outside metropolitan areas. There are a

number of sub-fields that affect Aboriginal and Torres Strait Islander health, all broadly

classed under a result of remote location. According to the census results, more than 20% of

ATSI people live in remote communities (ABS, 2019) and are at severe risk of adopting

dangerous health behaviours opposed to those living in urban or metropolitan areas

(Australian Health and Welfare Institute, 2019). Remote location strips ATSI peoples of

constant access to fresh fruit and vegetables and access to good, quality education, two

importantly, deemed necessities, explored in further detail below. These restrictions have a

high likelihood of leading to health related issues such as malnutrition and diabetes which

can lead to further complications in health.

Lack of Fresh Produce

To obtain or uphold a good health, a balanced and healthy diet is needed. A healthy diet is a

diet that helps maintain or improve the health of one’s self (NHS, 2019). A balanced diet

consists of a range of different types of food that provide adequate nutrition to all parts of the

body. Foods include fresh produce such as fruit and vegetables that supply you with

nutrients, and others such as nuts and legumes that supply you with fibre. Without an

adequate healthy and balanced diet, problems such as malnutrition or worse can arise.

Unfortunately for ATSI people living in remote areas of Australia, access to the

aforementioned is quite scarce and what is available is costly. Remote location consequently

results in long and tiresome delivery, “the further distance required to deliver, the more

expensive and infrequent it is going to be, especially fresh produce as more is required to

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keep it in good condition” (Amanda Marshall, 2018). In the Northern Territory, fresh fruit

and vegetables are grown but are exported overseas, this results in having to buy from

interstate growers. This in itself results in metropolitan areas of the NT to often fall culprit to

expensive fresh produce prices, if populated cities such as Darwin and Alice Springs have

expensive produce, it is no surprise that it is more expensive to export it elsewhere in the

territory.

In comparison to expensive and minimal fresh produce, unhealthy alternatives such as frozen

fried goods, soft drinks, juices and lollies are sold in substantial amounts for small prices.

This is seen as a more affordable option to many, as more food can be obtained for a smaller

price, however this food severely lacks good means of nutrition and vitamins. Rural ATSI

communities lack education to inform Indigenous peoples of the dangers of high

consumption of these foods. The “more for less” mindset can only conclude in a diet

consisting of fried and sugary goods opening up gateways to type 2 diabetes and heart disease

explored in further detail below (The Conversation, 2019). A viable solution to the ever-

growing problem of expensive fresh produce in rural communities could be to locally source.

Instead of shipping our locally grown produce overseas and retrieving it from interstate, the

Northern Territory could distribute it locally around the territory solving a multitude of

problems for local and rural communities in the territory. This solution would increase the

percentage of nutritional food available in Indigenous communities rendering the ATSI

population healthier. However, if implemented a lot of financial issues and disruptions

amongst the Northern Territory could arise.

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Lack of Good Education

One thing Aboriginal and Torres Strait Islander communities severely lack as a result of their

remote location is quality and consistent education. Remote location embeds multiple

problems into the schooling of Indigenous youth. The overall school attendance rate per day

for indigenous children is 63.2% compared to non-indigenous Australians with 93.0%

(Australian Indigenous Education Chapter, 2017). Education is an important and vital part of

the growth and development of a young person. School is responsible for not only expanding

the knowledge of one but also culturing them on many healthy and fundamental aspects of

life, in hope of setting youth up for a good future.

Multiple factors that make education hard in remote Indigenous communities are expenses,

language barriers, bad memories of school and uneducated parents. Many remote Indigenous

communities live in poverty and therefore financial priorities are not put on schooling.

Furthermore, language is a big part of the aboriginal culture and many children do not speak

English; with only 0.7% of Australian teachers identifying as Indigenous, educators that

share the language are few and far between (Creative Spirits, 2019). Children often

experience school related trauma due to past experiences either themselves or their elders

have gone through such as abuse, neglect, racism, forced removals or violence all as a result

of colonisation. This trauma can affect how they view the school staff and in turn whether

they feel safe attending (Kids Matter, 2019).

Lack of education, leads to a stripped knowledge of how to live a healthy life, often being the

rooting cause of risky health choices and poor decision-making skills. In strong reference to

the previous paragraphs, a compromised knowledge of healthy choices can result in higher

susceptibility to diseases discussed in detail as follows. It would perhaps be wise to create

easy access from remote communities to a schooling system, whether that be in person or

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online. Perhaps a lesson with local communities could be held every so often, where teachers

from a variety of different places fly out to remote locations and attempt to culture the

students on basic and important fundamentals.

The Two Main Predominant Diseases Amongst the Remote Communities: A Direct

Result of Remote Location

Diabetes

Diabetes is a prevalent disease amongst the ATSI remote community, with the community

said to be four times more at risk compared to non-indigenous Australian’s (Diabetes

Australia, 2019). As touched on above, remote communities have limited access to affordable

and quality fresh produce, as a direct result of this people turn to consumption of unhealthy

and largely portioned food such as fried goods and soft drinks. These unhealthy foods are

typically high in sugars and fats. The over consumption of sugar and fats can lead to too

much glucose (sugar) located in the blood stream, resulting in diabetes, most commonly in

the case of Indigenous Australians, type 2 diabetes. Diabetes is responsible for two times

more deaths in remote Indigenous communities, compared to those in metropolitan areas as

doctor treatments and hospitals are more ubiquitous in remote locations (Health Info Net,

2019).

Heart Disease

Heart Disease is one of two main causes of death for ATSI people living in remote locations.

When compared with non-Indigenous Australians, data shows that ATSI people are 70%

more likely to die from circulatory or cardiovascular diseases, a truly shocking statistic

(Heart Foundation, 2019). The reason rates of cardiac failure are so prominent in the ATSI

community is largely to do with the poor nutrition in food consumed by the population. As

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mentioned above, a solution could be to locally source or grow produce in help of promoting

a change in the nutrition consumption of ATSI peoples.

The Census: An Important Role in Helping Determine the ATSI Population in

Australia

In Australia, the census is the most widely used and effective method of collecting statistical

information regarding the Aboriginal and Torres Strait Islander population (ABS, 2019). It

provides a basic overview of how the remote communities population of ATSI people is

fluctuating in growth overtime, as well as attempting to give motive to governments to work

on organisations to bring indigenous remote health and the health of others align. The

estimated ATSI population inhabiting remote areas around Australia, as of 2016 is 20%, with

Northern Territory holding 49% of that percentage in rural communities (ABS, 2019). The

census does give an approximate value to the population in each area, however, it is often

difficult to give a precise population number of ATSI people as the census goes unsigned for

some making it difficult to achieve precise statistics.

Based on the results from the census, governments and non-government organisations are

able to develop campaigns and initiatives such as “Close the Gap”. The results help depict

how much help is needed in these areas and gives an estimation of those struggling.

Current Government Campaigns/ Organisations: Are They Helping?

There are multiple organisations and campaigns happening to help improve the quality of life

of ATSI people living in remote communities, the main government run organisation is the

“Close the Gap” campaign. This campaign was initiated back in 2005 and aims to close the

gap in life expectancy between Indigenous and non-indigenous Australian’s by the year 2030.

It aims to improve the health of those in remote communities by providing funding for

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healthy produce availability and pricing, as well as education for youth. The government also

aimed to halve the mortality rate of indigenous children and halve the gap in employment

outcomes between indigenous and non-indigenous Australians. In the past few years, some

progress has been made however there have been no significant results.

Target dates have been compromised as of recently with more than $530 million of funding

being cut by the government from the Indigenous Affairs portfolio (ANTar , 2019). This

shocking deduction has created a massive stunt in the aims and growth of this project, with

statistics showing minimal change within the past year. With Indigenous funding alone there

is not enough power to close the gap. In order for change to be put in place, commitment and

funding from the government is required as well as petitions from the community. This can

pave the way for improving indigenous health with an ultimate goal of closing the gap once

and for all (ABC, 2018).

Reflecting on current date, national “Close the Gap” days run every year on the 17th of March

in hope of raising further awareness. This year’s “Close the Gap” report theme was “Our

health, our voice, our choice”. A report is drawn up every year reflecting on the progress

made surrounding the campaign, and the further progress required to complete the 2030 goal

of closing the gap. The report states that there are three main areas of focus, “targeted, solid

based primary healthcare, a responsive healthcare system and good housing for good health”

(News GP, 2019). The report comments on the positive communal response of awareness

promotion activities and additionally how if a true change is desired members of the

community must be willing to change themselves; the initiative “must be done ‘with’ the

community not ‘to’ the community” (Dr Tanya Schramm, 2019).

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Education: Community and Extension

As previously mentioned, education for Aboriginal and Torres Strait Islander youth can often

be scarce due to a number of factors such as cultural barriers, expenses and uneducated

parents. However, educating students and the broader community on issues present in

Indigenous remote communities is a step in the right direction of overall change. Culturing

people on issues present in society raises awareness and prompts others to help change long-

standing issues. Making others aware of the issues that need tackling is a vital step in overall

change; the more people alert about the issues; the more likely help and change is (United

Issues for Indigenous People, 2019).

Conclusion

It is evident that remote location plays a huge role in determining the health of the Aboriginal

and Torres Strait Islander population. Aforementioned statistics show that the mortality rate

of Indigenous peoples sits way higher in comparison to non-Indigenous due to factors all

deriving from remote location. These include lack of fresh produce leading to higher

susceptibility to certain diseases as well as a lack of good education which has an equal

ability to affect their health. With the proper education of Indigenous and non-Indigenous

communities, accompanied by funding from the government for campaigns such as “Close

the Gap”, there is hope and strong chance for progress.

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References

ABC News (2019). Closing the Gap policy 'effectively abandoned' amid funding cuts. [online]
Available at: https://www.abc.net.au/news/2018-02-08/closing-the-gap-review-finds-policy-effectively-
abandoned-by-gov/9405100 [Accessed 15 Feb. 2019].

Australian Bureau of Statistics (2019). 3238.0.55.001 - Estimates of Aboriginal and Torres Strait
Islander Australians, June 2016. [online] Available at:
https://www.abs.gov.au/ausstats/abs@.nsf/mf/3238.0.55.001 [Accessed 15 Feb. 2019].

Australian Institute of Health Welfare (2019). [online] Available at:

https://www.aihw.gov.au/getmedia/3fae0eb7-b2be-4ffc-9903-a414388af557/7_7-indigenous-health-
remoteness.pdf.aspx [Accessed 15 Feb. 2019].

Australians for Native Title and Reconcilation (2019). Health. [online] Available at:
https://antar.org.au/campaigns/health [Accessed 15 Feb. 2019].

Australian Institute of Health and Welfare. (2019). Diabetes Overview - Australian Institute of Health
and Welfare. [online] Available at: https://www.aihw.gov.au/reports-data/health-conditions-disability-
deaths/diabetes/overview [Accessed 15 Feb. 2019].

Diabetes Australia (2019). Aboriginal & Torres Strait Islander people. [online] Available at:
https://www.diabetesaustralia.com.au/aboriginal-and-torres-strait-islanders [Accessed 15 Feb. 2019].

Government Education (2019). Indigenous Education | Department of Education and Training. [online]
Available at: https://www.education.gov.au/indigenous-schooling [Accessed 15 Feb. 2019].

Jens Korff, C. (2019). Aboriginal population in Australia. [online] Creative Spirits. Available at:
https://www.creativespirits.info/aboriginalculture/people/aboriginal-population-in-australia [Accessed
15 Feb. 2019].

National Health Service (2019). Why 5 A Day?. [online] Available at: https://www.nhs.uk/live-well/eat-
well/why-5-a-day/ [Accessed 15 Feb. 2019].

Rural Health (2019). Demography. [online] Available at: https://ruralhealth.org.au/book/demography

[Accessed 15 Feb. 2019].

United Nations Organisation (2019). Culture | United Nations For Indigenous Peoples. [online]
Available at: https://www.un.org/development/desa/indigenouspeoples/mandated-areas1/culture.html
[Accessed 15 Feb. 2019].

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