Indigenous health gap reframed: Addressing root causes by poverty alleviation

This paper aims to establish the links between poverty and Indigenous health gap in Australia. An outline is given of what is known about the causes of Indigenous health inequity and challenges we face in combating them. Health inequality between Indigenous and non-Indigenous Australians will be described. Research on the causes of poor Indigenous health will be reviewed including biomedical, social and economic studies. Multiple statistical analyses are performed using morbidity, mortality and socioeconomic data to demonstrate Indigenous health is in fact a poverty issue. Age standardised hospital morbidity and life expectancy at birth are examined by means of both descriptive and analytical approach. This study clearly demonstrates that the proportion of Indigenous population is highly correlated with socioeconomic disadvantage. A clear socioeconomic gradient is found for all categories of disease and injury. Socioeconomic disadvantage accounts for one-third to one-half of the Indigenous life expectancy gap. Lifting area based poverty scores for family income and education/occupation by two quintile categories for low socioeconomic Indigenous groups appear to be sufficient to overcome the excess hospital utilisation among the Indigenous population. These findings suggest that poverty is the root cause of poor Indigenous health. Poor Indigenous health is mainly driven by environmental factors such as historical colonisation, social discrimination and resource exploitation. Problem with using race to describe ill-health is that race is not a modifiable risk factor and it indicates genetic factors may play a major role in causing poor Indigenous health. Many Indigenous people are very healthy, provided they are less likely exposed to risks of ill-health. The discussion leads to a conclusion that economic development and lifting poverty should play a central role in closing health gap between Indigenous and non-Indigenous population.