Close the Gap with refreshed focus on income, education, institutional racism

Thursday, March 21, 2019

‘Today is National Close the Gap Day—and to truly close that gap we badly need a refreshed focus on the social determinants of health, including income, education, racism and intergenerational trauma’, says Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven

‘These factors account for over one-half of the difference in health outcomes between Aboriginal and Torres Strait Islander people and non-Indigenous Australians.

‘To reduce such inequities, as a nation we need to have concrete action on things many non-Indigenous Australians take for granted. Things such as quality housing, effective education, jobs, community activities, access to healthy food and clean water, and access to appropriate healthcare.

‘When we say “appropriate healthcare” we mean more than medically appropriate—we mean culturally safe healthcare services.

‘When dealing with the healthcare sector Aboriginal and Torres Strait Islander peoples should feel safe and secure in their identity, culture and community. There should be no challenge to whether they should be able to access culturally safe services. Whether a service is “culturally safe” or not needs to be determined by Aboriginal and Torres Strait Islander people themselves.

‘In this vein, we have much to do in tackling institutional racism—which is different to individual racist acts, and mostly goes unacknowledged.

‘For example—a recently published study of the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry showed that Indigenous patients were less likely than non-Indigenous patients to be added to the transplantation waiting list during the first year of renal replacement therapy; this disparity was not explained by differences in patient- and disease-related factors. The authors concluded that changes in policy and practice are needed to reduce these differences.

‘There was also the case of a government department providing 26 different streams of funding for various ‘body parts’ (diabetes, heart disease and so on) to a holistic Aboriginal Medical Service—and then demanding 26 different streams of accountability for the money. Apart from the unreasonable reporting load, this kind of administration is screaming “we don’t trust you” to the funding recipients—and don’t imagine that they don’t feel it.

‘We need to go right back to the original 2008 Close the Gap Statement of Intent signed by the Council of Australian Governments (COAG). That statement was founded on an understanding that population health outcomes are fundamentally the result of social determinants and that governments need to work in partnership with Aboriginal and Torres Strait Islander peoples and their organisations to achieve beneficial outcomes.

‘The 2018 commitment by COAG to a formal partnership approach with Aboriginal and Torres Strait Islander peoples to Close the Gap is a long overdue step in the right direction.

‘In addition to Aboriginal and Torres Strait Islander peoples having a leadership role in Aboriginal health, let’s also ensure that there is strong investment in Aboriginal health services, and prioritised development of an Aboriginal health workforce to deliver both Aboriginal-specific and mainstream health services’, Ms Verhoeven said.

For more information on AHHA, see: see:

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, Primary Health Networks, and community and primary healthcare services.

Media enquiries:  

Alison VerhoevenChief Executive, Australian Healthcare and Hospitals Association                                   

0403 282 501