Dr John Condon paints a brighter picture of Indigenous Health
The focus of the seminar shifted from education to health on 12 April, when Dr John Condon presented a provocative paper titled “Is Indigenous health really getting worse: mythology and lazy science”. Building on the work already done by Len Smith, a demographer who calculated mortality rates for the NT’s indigenous population between 1957 and 1970, Dr Condon and his colleagues from the “People, Place and Economy” theme area at SSPR have recently collected and analysed data on Indigenous mortality rates that are valid up to the present day. Dr Condon notes that between 1967 and 2001, mortality rates declined for the NT’s Indigenous population, in all age-groups and for both sexes; declines were greater for younger and older people that in the early and middle adult years, and greater for women than men. Life expectancy increased by several years for both men and women over this period.
Dr Condon is an epidemiologist who has worked in the Northern Territory for over 25 years, and has extensive experience in primary health care in remote Indigenous communities; in health policy and administration; and in development of clinical information, data management and statistical reporting systems. The long-term analysis of mortality trends undertaken by Dr Condon and his colleagues demonstrated (as has been reported many times before) that “the gap between the health status of Indigenous and other Australians is very large indeed, and has remained large”. However, Dr Condon disagrees with the widely-held view that the overall health status of Indigenous Australians is not improving and may actually be getting worse. The evidence of falling Indigenous mortality rates and increasing life expectancy in the Northern Territory indicates that, rather than deteriorating, overall health status has improved in recent decades. Unfortunately, similar information on long-term health trends is not available for Indigenous people elsewhere in Australia, so we do not know whether Indigenous health status is static elsewhere or is improving as in the NT.
Dr Condon questions why commentators have adopted such a pessimistic outlook in recent years. The absence of research and routine statistics about long-term health trends for Indigenous people is the most important factor; government statistical agencies and the research community have indeed been ‘lazy’ in this regard. Simply by inferring indigenous status from the personal information included on death certificates, Dr Condon and his colleagues were able to obtain accurate data on Indigenous mortality rates in the NT. Using this or other innovative methods, similar information could be available elsewhere in Australia where Indigenous people comprise a high proportion of the population, such as parts of Western Australia, South Australia, Queensland and perhaps even western New South Wales.
The absence of reliable information on long-term Indigenous health trends has led to a focus on short-term measures relative to the non-Indigenous population. For example, in one edition of the journal New Doctor, a special edition devoted to Indigenous health in 1999, Paul wrote “Recent reports indicate that whilst the health status of the Australian population as a whole has improved from 1988 to 1994, there has been no such change for Aboriginal and Torres Strait Islanders (Australian Institute of Health and Welfare, 1996). This has resulted in a widening of the gap in health status between Indigenous and non-Indigenous Australians.”
In his closing remarks, Dr Condon suggests that this pessimistic outlook might have been sustained for political reasons. Indigenous organisations and other groups lobbying for policy, resources and public opinion on Indigenous issues have long emphasised the enormous disparity between the health of Indigenous compared with other Australians. This emphasis has been appropriate and necessary, but the message has remained static for many years.
“Will they welcome news of progress, or does continuing bad news better suit their purpose? I would suggest that they should definitely welcome good news, even if it contradicts their own recent positions. A small change in emphasis, from “it’s not getting better and something needs to be done” to “it’s not getting better fast enough and more needs to be done” is a big change in outlook, from pessimism to optimism. The evidence of long-term trends in Indigenous health status, incomplete though it is, supports the optimistic outlook that the effort of recent decades has not been wasted, and that increased and sustained effort will increase the pace of improvement.”
WSM
