Closing the gap to 2030

Closing_the_Gap_2015_coverIt was the anthropologist Bill Stanner who described Australia’s attitude to its Indigenous people as a “great history of indifference”. Stanner was speaking in 1963, just after Aboriginal and Torres Straight Islanders (hereafter ATSI) got the vote.

That brought Indigenous people into the Australian story, a process accelerated by the 1967 referendum that ensured “Aboriginal” people (ATSI people) were counted in the census and the Commonwealth had a role to play. One of the referendum’s instigators, Faith Bandler who died yesterday aged 96, wasn’t Indigenous but her polyglot Melanesian-Scottish-Indian background was emblematic of a new Australia gradually looking beyond the coattails of empire for inspiration, and prepared to dig deep for the descendants of its original inhabitants.

Australia’s story over the last 50 years has been one of an attractive, open, vast and vibrant country with great wealth and freedom, attracting people from around the world. The conditions of ATSI people has greatly improved in that time but because they started from a low ebb, they remain adrift of the general population in most statistical markers. Their place on the census allowed economists to easily measure the state of the gap while Commonwealth involvement gave the problem a much needed national focus.

In March 2008, Kevin Rudd used his popularity as prime minister to coax the new Australian Government and Opposition to sign the Close the Gap Statement of Intent. Rudd hosted the Indigenous Health Equality Summit which committed to closing the health equality gap between ATSI and non-Indigenous Australians by 2030.

The rationale was a dichotomy revealed by the UN Human Development Index which ranked Australia third in the world off the back of its mining boom. The score ranked Australia highly on such matters as life expectancy, employment, health and other indicators. Yet the life expectancy of an ATSI person was 17 years less than the Australian average.

The gap was a stark reminder of a great divide in Australia across education, incoming, housing, mental health, chronic disease, child and maternal health, and access to health services. The gap led to an immense burden of suffering and grief for ATSI people which was a “scar on an unhealed past” and a “stain on the reputation of the nation”.

The impact is felt by the states as well. Victoria and Queensland got on board the Statement of Intent in 2008, WA in 2009, the ACT, NSW and SA in 2010. WA and NT have not yet signed up but the committee recognises states have as big a role to play as Canberra. They spend the Commonwealth tax dollar on health and education.

But the Commonwealth takes the lead, producing the Closing the Gap report since 2008. In this issue as in many others Rudd overpromised and underdelivered yet there has been much progress in seven years. The improvement is hard to see because while Aboriginal health has improved, the health of the general community is also improving. We are failing to “close the gap” fast enough.

Women are bearing the brunt of the problem. In the last five years, Indigenous life expectancy has gone up by 1.6 years for men but just 0.6 for women. Both sexes still die 10 years earlier than non-Indigenous people, so the good thing is the gap has narrowed by seven years since 2008 and is a reminder that closing the gap takes a lot of continuous effort and time. In New Zealand it took 20 years to improve Maori life expectancy by four years.

Prime Minister Gillard never had the same focus as Rudd on Indigenous affairs. She guided a minority government through many controversial issues but ATSI legislation never floated to the top. In her final closing the gap report in 2013 she claimed victory on access to remote pre-schools but admitted there was still a “massive and unacceptable” standard of living gap between Indigenous and non-Indigenous Australians.

Last year was the first Closing the Gap report of the post-Labor era. Like John Howard, Tony Abbott put great store in what he called “practical reconciliation” (ruling self-determination off the table.) Like in the Labor years, the report spoke of the “stark reality of health inequality” and called for measures to reduce smoking rates, improve maternal and children’s health and to make inroads into chronic disease.

This year is much the same. The committee wants greater focus on access to primary health care services to detect, treat and manage Indigenous health conditions. They have evidence to suggest Aboriginal Community Controlled Health Services gives the best bang for contested government dollars, providing wide-scale, quality access to health services.

The committee supports the government’s priorities of education, employment and community safety. But they want the Closing the Gap strategy to have a “clearer connection” with the Indigenous Advancement Strategy. Education, employment and community safety lead to good health but good health is also important to driving education, employment and community safety. Health services is the bigger employer of Indigenous people so increased investment will lead to increased employment.

The year 2030 remains the target and by then we should see a further shrinking of difference. But “the gap” must remain a priority well beyond then. Indigenous injustices, shielded by settler indifference for 180 years, cannot be wiped away in the health service schemes of a single generation. There must be continued commitment to the removal of the gap for ATSI people as populations. But integration or assimilation is not the complete answer. There must also be a commitment to support ATSI people as distinct peoples with their own culture and languages, regardless of health and employment outcomes.

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