Shadow Report 2012 On Australian governments’ progress towards closing the gap in life expectancy between Indigenous and non-Indigenous Australians Close the Gap Campaign Steering Committee Who we are Acknowledgments Australia’s peak Aboriginal and Torres Strait Islander and non-Indigenous health bodies, health professional bodies and human rights organisations operate the Close This shadow report is a collaborative the Gap Campaign. The Campaign’s goal is to raise the health and life expectancy effort of the Close the Gap Campaign of Aboriginal and Torres Strait Islander peoples to that of the non-Indigenous Steering Committee. Funding for, and population within a generation: to close the gap by 2030. It aims to do this through project management of the report was the implementation of a human rights based approach set out in the Aboriginal and provided by Oxfam Australia. Torres Strait Islander Social Justice Commissioner’s Social Justice Report 2005.1 Author: Christopher Holland, The Campaign’s Steering Committee first met in March 2006. Our patrons, Senior Policy Officer, Australian Catherine Freeman OAM and lan Thorpe OAM, launched the campaign in April Human Rights Commission and 2007. To date, 176,000 Australians have formally pledged their support. In Executive Officer, Close the Gap August 2010 and 2011, the National Rugby League dedicated an annual round Campaign Steering Committee of matches as a Close the Gap round, reaching around 3 million Australians Secretariat and National Health per round. 840 community events involving 130,000 Australians were held on Leadership Forum Secretariat National Close the Gap Day in 2011. Editor: Andrew Meehan, Indigenous The Campaign began to shape policy in 2007–08. Notably: Rights Advocacy Lead, Oxfam Australia • COAG set two Closing the Gap Targets for achieving Aboriginal and Design and print coordinator: Torres Strait Islander health equality within a generation and for halving JAG Designs the under-fives mortality rate gap within a decade); and • former Prime Minister Kevin Rudd and other Australian Government and Published by: Opposition party representatives2 signed the Close the Gap Statement The Close the Gap Campaign Steering of Intent in March 2008 at the Campaign’s National Indigenous Health Committee, February 2012 Equality Summit. The current Prime Minister and Opposition Leader, © Close the Gap Campaign Steering along with the Greens, have indicated their parties’ continuing support on Committee for Indigenous Health subsequent occasions. The Statement of Intent remains the touchstone of Equality, February 2012. the Campaign and is reproduced on page 5. This work is licensed under the The Campaign has also provided significant impetus for the seven ‘closing the Creative Commons Attribution – gap’ National Partnership Agreements agreed since November 2008. These have NonCommercial – ShareAlike 2.5 brought with them approximately $5bn in additional resources, including the Australia License. To view a copy of $1.6bn attached to the National Partnership Agreement on Closing the Gap in this license, visit: Indigenous Health Outcomes. http://creativecommons.org/licenses/ The Campaign Steering Committee is led by its Aboriginal and Torres Strait by-nc-sa/2.5/au or send a letter to Islander member-organisations. This leadership group was the precursor for Creative Commons, 171 Second the National Health Leadership Forum (NHLF) within the National Congress of Street, Suite 300, San Francisco, Australia’s First Peoples that formed in 2011 and is discussed on page 16. The California, 94105, USA. NHLF now leads the Close the Gap Campaign for Indigenous Health Equality Copies of this report and more with Jody Broun, Co-chair of National Congress of Australia’s First Peoples, and information are available to download Mick Gooda, Aboriginal and Torres Strait Islander Social Justice Commissioner, at: www.humanrights.gov.au/social_ co-chairing the Campaign Steering Committee. justice/health/index.html and Clarification of the terms ‘Close the Gap’ and ‘Closing the Gap’ www.oxfam.org.au/closethegap “Close the Gap” was adopted as the name of the human rights-based campaign Cover photograph: for Aboriginal and Torres Strait Islander health equality led by the Close the Gap Darren Mercy and daughter Avril Mercy Campaign Steering Committee in 2006. The term ‘closing the gap’ entered the play in the garden outside Galambila policy lexicon as a result of the Close the Gap Campaign’s activities and has Aboriginal Health. since been used to tag COAG and Australian Government Aboriginal and Torres Photograph: Jason Malouin/OxfamAUS. Strait Islander policy initiatives aimed at reducing disadvantage – from the COAG Closing the Gap Targets to the National Partnership Agreement to Closing the Aboriginal and Torres Strait Islander Gap on Indigenous Health Outcomes. people should be aware that this document may contain images or As a general rule, any initiative with “closing the gap” in the title is an Australian names of people who have since Government or COAG initiative. It is important to note that it does not necessarily passed away. reflect the human rights-based approach of the Close the Gap Campaign, nor does the use of the term reflect an endorsement of them by the Close the Gap Campaign Steering Committee. Close the Gap Campaign Steering Committee Contents Co-chairs Executive Summary 2 • Ms Jody Broun, Co-chair of the National Congress of Australia’s First Introduction 4 Peoples* Part 1: 8 • Mr Mick Gooda, Aboriginal and Torres Strait Islander Social Justice Progress towards the Commissioner, Australian Human Rights Commission achievement of Aboriginal and Torres Strait Islander Members health equality within a • Australian Indigenous Doctors’ Association* generation • Australian Indigenous Psychologists’ Association* 1. Progress against the COAG Closing the Gap targets 9 • Congress of Aboriginal and Torres Strait Islander Nurses* 2. Progress in relation to the • Indigenous Allied Health Australia Inc.* National Partnership Agreement • Indigenous Dentists’ Association of Australia* on Closing the Gap in Indigenous Health Outcomes 13 • National Aboriginal Community Controlled Health Organisation* 3. Developments in relation to • National Aboriginal and Torres Strait Islander Health Workers’ Association* planning and partnership 15 • National Association of Aboriginal and Torres Strait Islander Physiotherapists* Part 2: 20 Progress at the state • National Coordinator — Tackling Indigenous Smoking (Dr Tom Calma – and territory level Campaign founder and former Aboriginal and Torres Strait Islander Social Justice Commissioner) 1. State and territory indicative trajectories for achieving the • National Indigenous Drug and Alcohol Committee COAG Closing the Gap targets • The Lowitja Institute* for life expectancy and under-five mortality 21 • Torres Strait Island Regional Authority* 2. Progress in jurisdictions that • Australian General Practice Network signed the Close the Gap Statement of Intent 24 • Aboriginal Health and Medical Research Council (a) Queensland 24 • Australian Human Rights Commission (Secretariat) (b) Victoria 25 • Australian Medical Association (c) Western Australia 27 (d) Australian Capital Territory 29 • Australians for Native Title and Reconciliation (e) New South Wales 31 • Australian Peak Nursing and Midwifery Forum (f) South Australia 33 • The Fred Hollows Foundation Conclusion 35 • Heart Foundation Australia Endnotes 36 • Menzies School of Health Research • Oxfam Australia • Palliative Care Australia • Royal Australasian College of Physicians • Royal Australian College of General Practitioners • Professor Ian Ring, Wollongong University (expert adviser) * Denotes additional membership of the National Health Leadership Forum of the National Congress of Australia’s First Peoples. 1 Executive Summary What is the gap? The closing the gap health and health related-programs have continued to be rolled out in the past year and have the potential to make significant headway in relation to smoking cessation, The Australian Bureau infant health and chronic disease. But over three years after the programs were announced, of Statistics estimates we are not yet in a position to accurately assess if Aboriginal and Torres Strait Islander life Aboriginal and Torres Strait expectancy is increasing in absolute terms, let alone whether the all-important relative gains Islander life expectancy are being made to close the 10 to 11 year gap with the non-Indigenous population.4 for 2005–07 to be 67.2 years for males: an 11.5 The most recent Aboriginal and Torres Strait Islander life expectancy estimate is for 2005–07. year gap compared with The methodology for calculating Aboriginal and Torres Strait Islander life expectancy relies on non-Indigenous males, and the Census for verification and, as a result, we have up to two years to wait before a current estimate verified by 2011 Census data is available. It is absolutely vital that we have this 72.9 years for females, information sooner if we are to learn in a timely fashion from the first three years of the closing which was 9.7 years lower the gap program, and – over time – from all the phases of the closing the gap effort (until 2030). than for non-Indigenous To ensure this happens Australian governments must be able to provide Aboriginal and Torres females.3 Strait Islander life expectancy estimates at time intervals shorter than five or more years. Otherwise there are mixed signals in the data. If current trends continue, Aboriginal