Aboriginal and Torres Strait Islander Australians continue to experience lower levels of access to health services than the general population: in 2006-2010, their age-standardized mortality rate was 1.9 times higher compared with non-indigenous Australians. They are more likely to be hospitalized for most diseases and conditions; to experience disability and reduced quality of life due to ill health; and to die at younger ages than other Australians. Aboriginal and Torres Strait Islanders also suffer a higher burden of emotional distress and possible mental illness than that experienced by the wider community.[14] Aboriginal and Torres Strait Islander women also experience poorer health across all areas compared with non-indigenous women.[15]

The issue of health disparity for Aborigines and Torres Strait Islanders first gained focused political attention with the publication of the 2005 Social Justice Report by the Australian Human Rights Commission. The report highlighted the vast gap between the health of indigenous and other Australians and called on Australian state and federal governments to commit to achieving Aboriginal and Torres Strait Islander health equality within 25 years. Following the release of the report, 40 of Australia's leading indigenous and non-indigenous health bodies and human rights organizations joined forces to launch the Close the Gap Campaign for Indigenous Health Equality. Now in its seventh year of operation, the two primary objectives of the campaign are: to close the gap in life expectancy within a generation and to halve the gap in mortality rates for indigenous children under the age of 5 within a decade (by 2018).

Importantly, the campaign was accompanied by a commitment of AU$1.57 billion over four years (2009-13) to tackle the burden of chronic disease. In April 2013 the federal government renewed its commitment for a further three years, pledging AU$777 million for the period. Although the government releases annual progress reports, there is a paucity of hard data, in part due to the difficulty in measuring outcomes. However, the latest government report indicated that in 2012 the target for under-five mortality was on track to be met in 2013, and that significant progress had been made against the target to halve the gap between indigenous and non-indigenous under-five mortality by 2018.[16]

Other important outcomes of the Close the Gap Campaign have been the reform of Australia's indigenous health institutional framework. In particular, the National Aboriginal and Torres Strait Islander Health Equality Council (NATSIHEC) was developed to provide a forum through which the government can work in partnership with the community and the indigenous health sector to implement its Close the Gap initiatives, and in 2012 focused on the development of the National Aboriginal and Torres Strait Islander Health Plan (the Plan). Furthermore, the newly established National Congress of Australia's First Peoples (Congress), has already indicated that health is one of its top priorities. At the end of 2011, the Congress teamed with 11 Aboriginal and Torres Strait Islander health groups to establish the National Health Leadership Forum (NHLF). The NHLF goal is to ensure the active involvement of Aboriginal and Torres Strait Islander communities in health policy at a national level.

The year 2012 was also a significant one for Aboriginal and Torres Strait Islander people because of the important political momentum gained regarding recognition of their status in the Australian Constitution. Following extensive consultations held throughout 2011, an expert panel – which included indigenous and community leaders, constitutional experts and parliamentarians – reported to the Prime Minister in January 2012.

It recommended that Australians should vote in a referendum to:

  • recognize Aboriginal and Torres Strait Islander peoples and to preserve the Australian government's ability to pass laws for the benefit of Aboriginal and Torres Strait Islander peoples;

  • ban racial discrimination by government authorities; and

  • recognize that Aboriginal and Torres Strait Islander languages were the country's first tongues, while confirming that English is Australia's national language.

Parliament set up a joint select committee on constitutional recognition of Aboriginal and Torres Strait Islander Peoples in November 2012 and has been asked to consult further on the model, and to help to ensure strong cross-party support so that a proposal can be put to the Australian people at a referendum.

The government also released the Human Rights and Anti-Discrimination Bill in 2012, which consolidated Commonwealth laws covering discrimination on the basis of race, sex, disability and age, and added new protections from discrimination on the grounds of sexual orientation and gender identity. It also strengthened protections against workplace discrimination on the basis of other attributes, including religion and political opinion. Delays, however, have meant that the bill has not yet passed into law.

Minorities and migration

The issue of irregular migrants arriving by boat and the processing of asylum seekers remained an issue of national importance, in particular in the lead-up to the September 2013 national elections. In June 2012, two boats sank within a week of each other, each carrying migrants trying to reach Australia by sea. An estimated 100 people died. This tragedy has been followed by numerous others, with ongoing deaths at sea throughout 2012 by migrants attempting to reach Australia by boat.

Following these incidents, on 28 June 2012 the Australian government appointed an expert panel on asylum seekers which recommended legislative amendments to allow for the transfer of asylum seekers who arrive in Australia by boat to third countries for the processing of their claims for protection. The proposal in effect re-launched Australia's 'Pacific Solution', a policy by which Australia transports asylum seekers to detention centres on small island nations in the Pacific Ocean. On 13 August 2012, the government passed amendments to the Migration Act, followed by legislative instruments designating Nauru and Papua New Guinea as 'regional processing countries'.

In November 2012, a bill to amend the Migration Act to extend this liability to all asylum seekers who arrive by boat, even if they reach the mainland, was introduced into parliament.

Although the Joint Parliamentary Committee on Human Rights found that Australia's offshore processing laws raise 'significant and complex issues' as to their compatibility with human rights and ordered an inquiry into the legislation, offshore processing continued. There remain serious concerns about the health and mental health impacts of prolonged and indefinite immigration detention.

In particular, Nauru and Manus Island pose specific health concerns for possible asylum seekers detained there. Nauru's acting Health Secretary acknowledged that the island would be unable to cope with any mental health issues of detainees. Moreover, in Manus Island there have been reports of a strain of malaria which can kill if left untreated for just one day.

In October 2012 the Australian government put forward the Migration Amendment (Healthcare for Asylum Seekers) Bill for consultation. Civil society organizations have welcomed the bill's proposal to establish an independent health advisory panel of experts to oversee the provision of health care to asylum seekers who are transferred to regional processing countries, including Nauru and Papua New Guinea. However, the Australian Human Rights Commission has also noted the need for more comprehensive monitoring of health and mental health services across Australia's immigration detention network.


Notes

14. MacRae, A., Thomson, N., Anomie, Burns, J., Catto, M., Gray, C. et al., Overview of Australian Indigenous Health Status, 2012, retrieved July 2013, http://www.healthinfonet.ecu.edu.au/health-facts/overviews.

15. Burns, J., Maling, C.M. and Thomson, N., 'Summary of indigenous women's health', Australian Indigenous HelathInfoNet, 2010, retrieved July 2013, http://www.healthinfonet.ecu.edu.au/women-review.

16. Department of Families, Housing, Community Services and Indigenous Affairs, Closing the Gap: Prime Minister's Report 2011, p. 14, Canberra, 2013, retrieved July 2013, http://www.fahcsia.gov.au/sites/default/files/documents/02_2013/00313-c….

This is not a UNHCR publication. UNHCR is not responsible for, nor does it necessarily endorse, its content. Any views expressed are solely those of the author or publisher and do not necessarily reflect those of UNHCR, the United Nations or its Member States.