Historical context and social determinants of Indigenous health
There is a clear relationship between the social disadvantages experienced by Indigenous people and their current health status [1]. These social disadvantages, directly related to dispossession and characterised by poverty and powerlessness, are reflected in measures of education, employment, and income. Before presenting the key indicators of Indigenous health status, it is important, therefore, to provide a brief summary of the context within which these indicators should be considered.
The historical context of Indigenous health
Indigenous peoples generally enjoyed better health in 1788 than most people living in Europe [2][3][4][5][6]. …show more content…
In addition to the impacts of introduced diseases and conflict, the spread of non-Indigenous peoples undermined the ability of Indigenous people to lead healthy lives by devaluing their culture, destroying their traditional food base, separating families, and dispossessing whole communities [3][4][7]. This loss of autonomy undermined social vitality, which, in turn, affected the capacity to meet challenges, including health challenges; a cycle of dispossession, demoralisation, and poor health was …show more content…
Detailed information about the geographic distribution of the Indigenous population for 2011 is not yet available, but figures from the 2006 Census indicated that the majority of Indigenous people lived in cities and towns [26]. Slightly more than one-half of the Indigenous population lived in areas classified as 'major cities ' or 'inner regional ' areas, compared with almost nine-tenths of the non-Indigenous population. (As well as these two classifications of 'remoteness ' in terms of access to goods and services and opportunities for social interaction, the Australian Standard Geographical Classification (ASGC) has four other categories: 'outer regional ', 'remote ', 'very remote ', and 'migratory ' [27].) Almost one-quarter of Indigenous people lived in areas classified as 'remote ' or 'very remote ' in relation to having 'very little access to goods, services and opportunities for social interaction ' ([28], p.3). Less than 2% of non-Indigenous people lived in 'remote ' or 'very remote ' areas [26].
In terms of specific geographical areas, more than one-half (53%) of all Indigenous people counted in the 2011 Census lived in nine of the 57 Indigenous regions (based largely on the former Aboriginal and Torres Strait Islander Commission (ATSIC) regions) [25]. The three largest regions were in eastern Australia (Brisbane, NSW Central and the North Coast, and Sydney-Wollongong),