Health outcomes: Indigenous people

1
Health outcomes Indigenous people

• Life expectancy 17 years younger in Victoria than
  non-Indigenous
• Aboriginal youth are four times more likely to
  die before the age of 25, twice as likely to be
  obese
• 13.6 of births to Indigenous mothers had low
  birthweight compared with 6.8 for non-Indigenous
  births

2
Health outcomes New arrivals

• 4 out of 5 refugee children do not receive
  comprehensive health care
• Higher levels of diabetes, poorer levels of
  nutrition amongst some new arrival communities

3
Health outcomes People with disabilities

• 20 of Victorians report having a disability
• (ie. 1,033,080 people)
• 52.25 of people with a disability rate their
  health as good, very good or excellent, compared
  with 85.4 of all Victorians

4
Health outcomes Low income/SES

• Compared to people on higher incomes, people from
  low income households
• Experience poorer health
• Are more likely to engage in behaviours harmful
  to health (smoking, sedentary behaviour)
• The health of people with limited socioeconomic
  resources is improving at a much slower rate than
  higher income earners

5
Influences on health

• Examples
• Access to employment
• Access to education
• Housing
• Health, social and community infrastructure

6
Employment Who is left out?

• Employment
• some migrant groups, Indigenous
• People with disabilities

7
Education Who is left out?

• About 40.1 of Indigenous students finish a year
  12 education compared with 75.9 of
  non-Indigenous students (AIHW 2007)
• Female school completers from a low socioeconomic
  background are less likely to go on to university
  than boys from this background (Nelms 2007)
• Labourers, manufacturing workers, retail
  industry, lowest weekly incomes participate less
  in furthjer learning, mostly due to being too
  busy (44) or not being able to afford training
  (18) (ABS 2007).

8
Housing Who is left out?

• There is an over-representation of overseas-born
  residents in private rental households (AHURI
  2007).
• 2 of housing transactions in 2003 would be
  affordable to someone on an average income,
  compared with 13.5 in 1996 (The Age 2007)

9
Community infrastructureWho is left out? 1
10
Community infrastructureWho is left out? 2
Disability any limitation, restriction or
impairment which had lasted/will last at least 6
months and restricts everyday activities
11
The work still to do
12
Health inequalities

• Ensuring equity is about
• moving beyond equity of access to
• ensuring equity of opportunity and
• measuring equity of outcomes.

13
Equity triangle lens
14
Equity of access

• Cost
• Culturally appropriate service delivery
• Physical barriers

15
Equity of access Key questions

• Direct costs, but also reflect on service-related
  costs uniforms, equipment, child or respite care
• Culturally appropriate service delivery Cultural
  security being able to obtain the same level of
  service even if your values base is different
• Physical barriers Venue layout, do staff
  understand taxi subsidy support scheme, etc?

16
Equity of opportunity

• Employment/income opportunities
• Reflect on local place barriers and enablers
• Social influences linking/bridging capital and
  contact hypothesis

17
Equity of opportunityKey questions

• Where does the service/program fit on a continuum
  between unemployment and new work opportunities?
• How well do you understand what it is like to
  live in the local area? Housing stresses,
  transport access, shopping and recreation

18
Equity of impact and outcome

• Going beyond throughput measures
• WHO is using your services/programs?
• Can this be built into KPIs/contractual
  arrangements?

19
Equity of impact and outcome Key questions

• Does service/program use reflect the needs of the
  local population?
• What population demographics are collected on
  usage?
• How do you share successes with the community and
  participants?