This report in The Age on Tuesday was titled “death knell for homelands”. It said that “thousands of Aborigines living on their remote Northern Territory homelands will be forced to move to larger communities to receive key government services in a radical shake-up of indigenous policy”.
Professor Kerin O’Dea, Director of the Sansom Institute at the University of SA and someone with decades of experience in Indigenous health, wrote this strong piece for Crikey last year, calling for policymakers to acknowledge the scientific evidence suggesting that there can be very positive health benefits for Aboriginal people who live on their homelands.
Health economist Professor Gavin Mooney has written an article in today’s Crikey bulletin making a similar argument.
This week, the Medical Journal of Australia, published the letter below from Dr David Scrimgeour, senior lecturer in public health at the University of Adelaide.
It makes you wonder about the sincerity of the Government’s mantra of “evidence-based policy”. Mind you, and I could be wrong, but I don’t think I’ve heard the mantra being repeated quite so often lately, nor with quite so much reverence.
Text of letter published by the 18 May edition of the MJA:
Patterns of mortality in Indigenous adults in the Northern Territory, 1998–2003: are people living in remote areas worse off?
The current Australian Government is continuing previous policies that do not support decentralised communities, but rather encourage their residents to move to larger communities or regional centres, where mortality is higher.
These policies appear to be heavily influenced by allegations based on narrow economic arguments that the lack of “jobs” in small remote communities is a reason for them to be closed down.5 A minister in the previous federal government derided smaller remote communities as “cultural museums”.6
. . . will support improvements to the delivery of services across 26 remote locations across the Northern Territory, Western Australia, Queensland, New South Wales and South Australia. These locations represent some of the largest concentrations of Indigenous Australians in remote Australia.7
Apparently, over 1100 smaller communities will not receive new funding. This is likely to accelerate the drift from small communities to larger settlements and towns, increasing exposure to health risks. Evidence from the Journal and elsewhere suggests that this drift will increase Aboriginal mortality.
The current Australian Government has made a commitment to “close the gap” between Aboriginal and non-Aboriginal life expectancies. The Prime Minister has also stated that his government’s policies will be based on evidence.8
Yet current policies ignore the evidence for the health benefits that accrue to Aboriginal people living in small decentralised communities. These policies also ignore the known health risks associated with larger settlements. Consequently, such policies may widen rather than close the gap.
- Andreasyan K, Hoy W. Patterns of mortality in Indigenous adults in the Northern Territory, 1998–2003: are people living in remote areas worse off? Med J Aust 2009; 190: 307-311. <eMJA full text> <PubMed>
- Scrimgeour D. Town or country: which is best for Australia’s Indigenous peoples? Med J Aust 2007; 186: 532-533. <eMJA full text> <PubMed>
- Glover J, Tennant S, Page A. The impact of socioeconomic status and geographic location on Indigenous mortality in Australia 1997–1999. Occasional Paper Series: No. 1. Adelaide: Public Health Information Development Unit, 2004: 40.
- Morice R. Woman dancing dreaming: psychosocial benefits of the Aboriginal outstation movement. Med J Aust 1976; 2: 939-942. <PubMed>
- Johns G. No job no house: an economically strategic approach to remote Aboriginal housing. Canberra: Menzies Research Centre, 2009. http://www.mrcltd.org.au/research/indigenous-reports/No_Job_No_House.pdf (accessed Mar 2009).
- Australian Broadcasting Commission. Vanstone says remote Indigenous communities becoming “cultural museums”. AM [radio program], 9 Dec 2005. http://www.abc.net.au/am/content/2005/s1527233.htm (accessed Mar 2009).
- Australian Government Department of Families, Housing, Community Services and Indigenous Affairs. Closing the gap on Indigenous disadvantage: the challenge for Australia. http://www.fahcsia.gov.au/sa/indigenous/pubs/general/documents/closing_the_gap/p3.htm (accessed Mar 2009, link updated May 2009).
- Rudd K. Address to heads of agencies and members of senior executive service, Great Hall, Parliament House, Canberra. 30 Apr 2008. http://www.pm.gov.au/media/Speech/2008/speech_0226.cfm (accessed Mar 2009).