During the period from 2015 to 2017, the life expectancy of Aboriginal and Torres Strait Islander people was 71.6 years for men and 75.6 years for women, which was respectively 8.6 and 7.8 years lower than the life expectancy for non-Indigenous people. Still, overall mortality rates in Western Australia improved by 27% during the period between 2006 and 2018, narrowing the gap while still remaining a long way from closing it.
While life expectancy rates vary between regions, the data reflects that significant and ongoing work is needed to ensure all Australian people have the same access to healthcare, disease survival rates, and education if there is any hope of achieving the Closing the Gap targets to eliminate these disparities by 2031.
What Do Life Expectancy Measurements Tell Us?
Life expectancy is complex and is influenced by myriad elements of life, from employment status to housing, average income levels, and behavioural aspects like alcohol consumption, smoking, diet, and obesity. It is also important to recognise that the life expectancy gap changes not solely based on mortality among Aboriginal and Torres Strait Islander people, but also on the average life expectancy of non-Indigenous Australians.
As healthcare, treatments, and techniques evolve, and more people access early screening programmes, we might assume that these will increase life expectancy equally for all people, but this is incorrect. In fact, positive improvements have been recorded in mortality rates for First Nations people in regards to circulatory diseases such as stroke and heart disease. However, cancer mortality rates have worsened over the same period, with the level of mortality from cancer worse than for circulatory diseases for the first time in 2017.
Although age-standardised mortality rates improved from 2006 to 2018 by just under 10%, this coincides with a similar change in non-Indigenous life expectancies, meaning the gap has remained static.
Contributing Factors to Lower Life Expectancy in Indigenous Communities
To truly grasp why life expectancy is lower for Aboriginal and Torres Strait Islander people than for other ethnicities and communities, we have to look to the past. Much of this connects back to the assimilation policy and the destruction of families, opportunities, incomes, lives, and languages.
How did the assimilation policy affect the Indigenous people? As research by the National Library of Medicine explains, part of the issue is that there is a lack of understanding around the factors that affect health behaviours in Aboriginal communities, with key themes including:
- Cultural and social networks
- Racism and socioeconomic disadvantage
- Psychological distress and trauma
- The marginalisation of Indigenous people within their communities
While many people assume that a lower life expectancy is within the control of the person, such as choosing whether to smoke or drink alcohol, this study reflects that many health behaviours are impacted by factors outside of any individual’s control. Life expectancy is not solely health-dependent but relies on social determinants. These aspects account for at least 34% of the gap, whereas behavioural risk is attributed to 19%.
Colonisation caused ripples of disadvantage that continue to resonate. First Nations people were exposed to segregation, forced institutionalisation, and the loss of their histories, traditions, and ways of life.
This loss of liberty forever changed the social behaviours of entire social groups, with trans-generational long-term effects. For example, unemployment rates, which contribute to mortality data and life opportunities, remain starkly different, with the latest data reflecting 10% unemployment of Indigenous people compared to 4% for non-Indigenous Australians.
How Can We Close the Life Expectancy Gap?
Equal life expectancy is essential to a balanced, fair society in which all people experience equality, opportunity, and access to resources. The Closing the Gap Indigenous Health Campaign is focused on this core area as a partnership between human rights organisations, health bodies, and NGOs, aiming to halve mortality gaps for children under five within ten years and to achieve health equality within a generation.
The campaign has not yet met those targets but has committed to long-term plans to address disparities in access to health services and to ensure that Aboriginal and Torres Strait Islander people and their chosen representatives have a role in determining how best to meet health needs. The starting point may be to acknowledge and comprehend the impact of disadvantage and marginalisation directly caused by the assimilation policy rather than an uninformed assumption that differences in lifestyle and health behaviours are the primary driver of the life expectancy gap.