Aboriginal and Torres Strait Islander Health
You'll be able to describe traditional healing practices respectfully.
The Australian Institute of Health and Welfare's 2023 report found that Aboriginal and Torres Strait Islander Australians have a life expectancy up to 8 years shorter than non-Indigenous Australians, a gap driven not by biology, but by history, policy, and social disadvantage.
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Why do Aboriginal and Torres Strait Islander Australians have shorter average life expectancy, and what is being done?
How might where you live, your income, and your education affect your health?
● Know
- Traditional Aboriginal and Torres Strait Islander healing practices
- The historical factors that created current health disparities
- The Closing the Gap initiative and its targets
● Understand
- How colonisation impacted Indigenous health
- Why culturally safe healthcare improves outcomes
- The social determinants of health in Indigenous communities
● Can do
- Describe traditional healing practices respectfully
- Explain the factors contributing to Indigenous health disparities
- Discuss strategies for improving Indigenous health outcomes
The gap in life expectancy between Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians is one of the most pressing health challenges in the nation. On average, Indigenous Australians die roughly 8-10 years earlier than non-Indigenous Australians. This gap is not caused by genetic differences or a single factor. Instead, it reflects a complex web of social determinants of health: historical dispossession, lower educational attainment, higher unemployment, overcrowded housing, food insecurity, geographic isolation from healthcare, and ongoing racism.
These factors interact. Poor housing increases infectious disease transmission. Limited education reduces health literacy. Distance from clinics delays diagnosis and treatment. Discrimination in healthcare settings discourages people from seeking help. Addressing the gap requires action across all these areas simultaneously, health services alone cannot fix housing, education, and employment.
Text description
- Traditional medicine: more than 60,000 years of plant knowledge, holistic wellness and community care, valued alongside Western medicine today.
- Pre-1788, traditional health: bush medicine, holistic healing, strong community.
- 1788–1900, colonial era: smallpox and measles devastated communities; about a 90% population decline.
- 1900–2000, 20th century: removal policies; health disparities widened.
- 2008–now, Closing the Gap: targets for life expectancy, infant mortality and community-led care.
A remote Indigenous community with no running water and overcrowded homes experiences high rates of skin infections and rheumatic heart disease. Building adequate housing and ensuring clean water would reduce these diseases more effectively than antibiotics alone.
The Australian Government Closing the Gap strategy, developed in partnership with the Coalition of Peaks (Indigenous community-controlled organisations), sets targets across health, education, employment, and housing, recognising that health outcomes depend on far more than doctors and hospitals.
Click each sentence that supports the claim.
Community-led programs consistently achieve better health outcomes for Aboriginal and Torres Strait Islander peoples than top-down government interventions. When Indigenous communities design and deliver their own health services, uptake increases, trust improves, and culturally appropriate care becomes the norm rather than the exception. Aboriginal Community Controlled Health Services (ACCHSs) are clinics owned and run by Indigenous organisations. They provide comprehensive primary care, including immunisation, chronic disease management, mental health services, and health education tailored to local culture and language.
Evidence shows that ACCHSs achieve higher vaccination coverage, better chronic disease management, and lower hospitalisation rates than mainstream services serving similar populations. The key ingredients are cultural safety, community governance, and integrated care that addresses social needs alongside medical ones.
The Aboriginal Medical Service in Redfern, founded in 1971, was the first Indigenous community-controlled health service in Australia. It has served as a model for hundreds of ACCHSs nationwide, demonstrating that self-determination in health delivery produces measurable improvements.
The National Aboriginal Community Controlled Health Organisation (NACCHO) represents over 140 ACCHSs across Australia and advocates for policies that prioritise Indigenous leadership in closing the health gap.
Several health conditions disproportionately affect Aboriginal and Torres Strait Islander Australians, reflecting interacting social, environmental, historical, and health-service factors. Rheumatic heart disease (RHD) can develop after group A streptococcal (GAS) infection: in some people, an autoimmune response—when the immune system mistakenly targets the body’s own tissues—causes acute rheumatic fever (ARF), which can inflame and damage the heart; repeated ARF can lead to lasting valve damage and RHD. GAS commonly causes throat infection, and skin infection may also precede ARF in some settings, although evidence for that pathway is less certain. Overcrowded housing can increase opportunities for infections to spread. Type 2 diabetes is more common among Aboriginal and Torres Strait Islander Australians. An Australian Institute of Health and Welfare comparison of 2022–23 survey data found First Nations adults were about 2.3 times as likely as non-Indigenous adults to be living with type 2 diabetes, after age adjustment. This is a population estimate for that period, not a prediction for an individual. The pattern has multiple contributors: social and structural conditions shape exposure to risk factors and access to prevention and care, while individual factors, including genetic susceptibility, can also contribute.
Trachoma, an eye infection caused by bacteria, is the leading infectious cause of blindness worldwide and has affected some remote Australian Aboriginal and Torres Strait Islander communities; treatment and prevention depend on accessible, culturally safe health services as well as environmental conditions. Kidney disease and lower respiratory infections also occur at elevated rates. These conditions are preventable and treatable, but prevention requires addressing housing, water, nutrition, and access, not just medical care.
In April 2026, the World Health Organization validated Australia as having eliminated trachoma as a public health problem. This does not mean every infection is gone: trachoma can still occur in some communities. Australian surveillance reports that it has occurred primarily in remote and very remote Aboriginal communities in the Northern Territory, South Australia and Western Australia. Its distribution is shaped by interacting environmental conditions and access to health services; sustained community-led screening, treatment, hygiene support, and improvements to housing, water and sanitation have all contributed to progress.
The Rheumatic Heart Disease Australia registry, based at the Menzies School of Health Research in Darwin, tracks every case nationwide and works with communities to prevent new infections through housing improvement and timely antibiotic treatment.
- Rheumatic heart disease
- Type 2 diabetes
- Trachoma
- Lower respiratory infections
- Social and structural conditions shape population risk; diet and activity, individual circumstances, and genetic susceptibility can also contribute
- Overcrowding and exposure to tobacco smoke
- Poor sanitation and lack of clean water
- Crowded housing can increase GAS spread; an autoimmune response, in which the immune system mistakenly targets the body’s own tissues, can lead to ARF and later valve damage (RHD)
Closing the health gap is not just a health policy goal, it is a national moral and social imperative. Progress has been made: Indigenous infant mortality has fallen, smoking rates have declined, and more Indigenous students are completing Year 12 than ever before. But the gap in life expectancy remains stubborn, and some targets under the Closing the Gap framework are not on track.
Sustainable improvement requires long-term commitment across government, healthcare, education, and community sectors. It requires listening to Indigenous voices and respecting Indigenous leadership in designing solutions. It also requires non-Indigenous Australians to understand the historical and ongoing factors that create health inequity, rather than blaming individuals for their own poor health. Health is not just personal choice; it is shaped by the society and systems around us.
Between 2006 and 2018, Indigenous smoking rates fell from 51% to 43%, a significant improvement driven by community-led tobacco control programs. But the rate is still three times the non-Indigenous rate, showing that progress is possible yet uneven.
The Lowitja Institute, Australia national institute for Aboriginal and Torres Strait Islander health research, funds community-driven projects and trains Indigenous researchers, ensuring that evidence generation serves the communities it studies.
Wrong: "Indigenous health disparities are caused by genetic differences." No, the disparities reflect social determinants of health (housing, education, employment, healthcare access) and historical factors, not genetics. Indigenous Australians who have equal access to education and healthcare have much more similar health outcomes.
Right: The Indigenous health gap is driven by social determinants of health (housing, education, employment, healthcare access) and historical factors, not genetics. Indigenous Australians with equal access to education and healthcare have much more similar health outcomes.
Wrong: "Traditional medicine is not scientific and should be replaced by Western medicine." No, many traditional medicines have proven scientific validity (e.g., tea tree oil, eucalyptus). The most effective approach combines traditional knowledge with Western medicine, delivered in culturally safe ways.
Right: Many traditional medicines have proven scientific validity (e.g., tea tree oil, eucalyptus). The most effective approach combines traditional knowledge with Western medicine, delivered in culturally safe ways.
Wrong: "Closing the Gap has already solved Indigenous health disparities." No, while some targets have shown improvement, many gaps remain significant. Life expectancy, chronic disease rates, and child mortality still show substantial disparities. Ongoing, community-led effort is essential.
Right: While some Closing the Gap targets have shown improvement, many gaps remain significant. Life expectancy, chronic disease rates, and child mortality still show substantial disparities. Ongoing, community-led effort is essential.
Bush Medicine in Modern Australia
Commercialisation of bush medicine: Many Australian companies now market products based on traditional Aboriginal knowledge. Tea tree oil is a global industry worth hundreds of millions of dollars. However, this commercialisation raises questions about intellectual property rights and fair compensation for traditional knowledge holders. Some Indigenous communities are developing protocols to ensure they benefit from products derived from their knowledge.
The Northern Territory's Strongbala program: In Arnhem Land, the Strongbala ("strong men") program combines traditional healing knowledge with Western chronic disease management. Elders work alongside nurses and doctors to deliver diabetes and kidney disease care that respects cultural practices. Results show improved patient engagement and better health outcomes compared to standard care alone.
Indigenous rangers and health: The Indigenous Ranger Program employs Aboriginal and Torres Strait Islander people to manage land and sea Country. Research shows that "working on Country" improves mental health, reduces substance abuse, and strengthens cultural connection, all of which improve physical health. This demonstrates how connection to land and culture directly benefits health.
✍ Copy Into Your Books
▾Traditional Medicine
- Tea tree oil: antiseptic
- Eucalyptus: respiratory conditions
- Kakadu plum: highest vitamin C content
- Holistic approach: physical, emotional, spiritual
Historical Impacts
- New diseases (smallpox, measles)
- Dispossession from land
- Stolen Generations trauma
- Segregated healthcare
Closing the Gap
- Reduce life expectancy gap
- Community-controlled health services
- Cultural safety in healthcare
- Address social determinants
Respectful Research
Health Equity Analysis
At the start of this lesson, you thought about how Aboriginal and Torres Strait Islander Australians have a life expectancy up to 8 years shorter than non-Indigenous Australians, despite living in one of the world's wealthiest nations, and how history and community shape health so powerfully.
Now that you've worked through the lesson, can you explain what the social determinants of health are and how colonisation created lasting health inequalities? What did this lesson change or deepen in your thinking?
Q1. 1. Describe two traditional Aboriginal healing practices and explain how each relates to modern scientific understanding of health. 4 MARKS
Q2. 2. Explain how historical factors (disease, dispossession, Stolen Generations) created the health disparities seen today. Use the concept of social determinants of health. 4 MARKS
Q3. 3. Evaluate the effectiveness of the Closing the Gap initiative. What has worked well, and what barriers remain to achieving health equity? 4 MARKS
Revisit Your Thinking
Go back to your Think First answer. Has your understanding changed?
- How has this lesson changed your understanding of Indigenous health in Australia?
- What role can respectful, culturally safe healthcare play in improving health outcomes?
Model answers (click to reveal)
Answers
▾MCQ 1
C Kakadu plum (Terminalia ferdinandiana) contains the highest known concentration of vitamin C of any fruit, up to 100 times that of oranges.
MCQ 2
A The Stolen Generations refers to Aboriginal and Torres Strait Islander children who were forcibly removed from their families by government agencies between 1910 and 1970.
MCQ 3
C An Australian Institute of Health and Welfare comparison of 2022–23 survey data found First Nations adults were about 2.3 times as likely as non-Indigenous adults to be living with type 2 diabetes, after age adjustment. This describes a population difference, not any individual’s risk. Social and structural conditions are important contributors to population patterns, while individual factors, including genetic susceptibility, can also affect risk; neither alone explains every person’s health.
MCQ 4
B Cultural safety means healthcare that respects and incorporates a person's cultural identity, beliefs, and practices, leading to better trust and outcomes.
MCQ 5
B Research shows that Aboriginal Community Controlled Health Services achieve better health outcomes for Indigenous patients than mainstream services, due to cultural safety and community ownership.
Short Answer 1
Model answer: Two traditional Aboriginal healing practices with scientific relevance are: (1) Bush medicine the use of native plants for healing. For example, tea tree oil has proven antimicrobial properties and is now used globally in antiseptic products. Eucalyptus contains compounds effective for respiratory conditions. This demonstrates that traditional knowledge contains scientifically valid treatments developed through thousands of years of observation and experimentation. (2) Holistic healing the approach that health involves physical, emotional, social, and spiritual wellbeing. This aligns with the modern biopsychosocial model of health, which recognises that physical illness is influenced by psychological and social factors. Research shows that connection to Country, community, and culture improves mental health outcomes, reduces stress hormones, and supports immune function, validating the holistic approach scientifically.
Short Answer 2
Model answer: Historical factors have shaped health disparities through several pathways, including their effects on social determinants of health. Introduced diseases caused devastating population loss, while dispossession from land disrupted access to Country, food sources, livelihoods, and cultural practices. The forced removal of Aboriginal and Torres Strait Islander children—the Stolen Generations—separated children from family, community, and culture. The Bringing Them Home inquiry documented severe harms, including grief, trauma, and effects that can continue across generations. Survivors' experiences and responses vary; these outcomes are not inevitable, and many people, families, and communities show strength and resilience. Historical policies and continuing conditions have contributed to unequal access to education, secure housing, employment, and culturally safe healthcare. For example, overcrowded housing can increase infection transmission, while racism or inaccessible services can discourage care. These social and historical factors help explain population health patterns; they do not determine any individual's experience or health.
Short Answer 3
Model answer: The Closing the Gap initiative has achieved mixed results. What has worked well includes: significant reductions in Indigenous child mortality; improved early childhood education access; and the success of community-controlled health services in delivering better outcomes than mainstream services. Some states have made progress on life expectancy. However, major barriers remain. The national life expectancy gap is still about 8 years. Many targets have not been met on schedule. Key barriers include: insufficient funding and long-term commitment; top-down policy design that does not adequately involve Indigenous communities; ongoing racism in healthcare and society; and the fundamental social determinants (housing, education, employment) that remain unequal. Research consistently shows that community-led, culturally safe approaches achieve the best outcomes. The most effective strategy is to fund and empower Aboriginal Community Controlled Health Services, address social determinants through housing and education investment, and ensure Indigenous voices lead policy design. Closing the Gap requires not just health policy but genuine reconciliation and systemic change.