Overcoming Indigenous Disadvantage: Key Indicators 2005
Overview

	
 Commonwealth of Australia 2005
ISSN 1448 9805
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SCRGSP (Steering Committee for the Review of Government Service Provision) 2005, Overcoming Indigenous Disadvantage: Key Indicators 2005, Productivity Commission, Canberra.

Foreword
The commissioning of this series of Reports, of which this is the second instalment, reflects a new determination by Australian governments to address the root causes of disadvantage, so that in the Prime Minister’s words, we can have an Australia where Aboriginal and Torres Strait Islander peoples:
‘— whether born in a remote community or in one of our cities or regional centres — can grow up and reach their full potential in life.’
The shared goal is for Indigenous people ultimately to enjoy the same standard of living as other Australians — for them to be as healthy, as long-living and as able to participate in the social and economic life of the country. However, as the Prime Minister has also acknowledged, this cannot be achieved quickly or easily, and represents a long-term national commitment. The legacy of past injustices and misguided policies presents a major challenge.
The extent of the challenge in eliminating Indigenous disadvantage remains evident in the data assembled here. While there have been heartening improvements in some indicators since the first Report was released in late 2003, in many areas there have not, and in most the gulf between Indigenous and other Australians remains wide. 
That said, there is clearly more going on in Indigenous communities than can be captured by statistics. Our consultations across the country in preparing this Report have revealed many positive initiatives at the local level, often at the instigation of Indigenous people themselves, and involving constructive new relationships with government and private enterprises. Some of these initiatives have been revealed in this year’s Report through case studies and in an array of boxes devoted to ‘things that work’. 
A key function of this Report, which distinguishes it from other compilations, is to document outcomes for Indigenous people within a framework that has both a vision of what life should be for Indigenous people and a strategic focus on areas that need to be targeted if that longer-term vision is to be realised. It can therefore provide
governments with information needed to assess whether their policy interventions are having the intended impacts.
Another important feature of the Report is its concern with outcomes requiring a whole-of-government perspective. It challenges governments to think outside the traditional policy silos, to find solutions that cut across portfolio and jurisdictional boundaries. For example, effective schooling, particularly in the early years, is clearly important to ultimate educational outcomes. But this cannot be disassociated from children’s health, housing or family environment. And this in turn demonstrates the importance of collaborative approaches between governments and Indigenous people.
A number of new initiatives have been undertaken to achieve these ends, including the COAG trials, and it is important that we learn from these. It is also encouraging that most jurisdictions have now taken steps to incorporate this Report’s framework in their own policy development and review processes.
Since the release of the first Report, consultations have been held with many Indigenous people and organisations across the country. Their feedback and advice have been of great value and have influenced the development of this second Report. Of particular importance has been the feedback and input received on the complex issues of culture and governance. I believe some progress has been made in these important areas, but as in other areas of the Report, they need to be seen as a work in progress.
On behalf of the Steering Committee, I extend our appreciation for the continuing cooperation and commitment of all those involved in the preparation of this Report. I record in particular my thanks to Robert Fitzgerald, who took over from me as Convenor of the Working Group overseeing the development of the Report and has been closely involved in consultations. Finally, my thanks to all those who have given generously of their time to engage in the consultations that are so important to the ongoing usefulness of this Report.

Gary Banks
Chairman
July 2005

Contents
Foreword		III
Contents		V
Acronyms and abbreviations	IX
Glossary		XIII
Terms of reference	XVI
Overview		XIX
Headline indicators
1	Introduction	1.1
	1.1	Not just another statistical Report	1.2
	1.2	Background	1.3
	1.3	The process	1.4
	1.4	References	1.6
2	The framework	2.1
	2.1	The underpinnings	2.1
	2.2	The framework	2.4
	2.3	Feedback from consultations	2.9
	2.4	Culture	2.11
	2.5	Data issues	2.15
	2.6	References	2.19

3	Headline indicators	3.1
	3.1	Life expectancy at birth	3.2
	3.2	Rates of disability and/or core activity restriction	3.5
	3.3	Years 10 and 12 retention and attainment	3.14
	3.4	Post secondary education – participation and attainment	3.21
	3.5	Labour force participation and unemployment	3.28
	3.6	Household and individual income	3.38
	3.7	Home ownership	3.47
	3.8	Suicide and self-harm	3.54
	3.9	Substantiated child protection notifications	3.60
	3.10	Deaths from homicide and hospitalisations for assault	3.64
	3.11	Victim rates for crime	3.74
	3.12	Imprisonment and juvenile detention rates	3.77
	3.13	Future directions in data	3.87
	3.14	References	3.89
4	Strategic areas for action	4.1
5	Early child development and growth	5.1
	5.1	Rates of hospital admission for infectious diseases	5.3
	5.2	Infant mortality	5.8
	5.3	Birthweight	5.10
	5.4	Hearing impediments	5.14
	5.5	Future directions in data	5.19
	5.6	References	5.20

6	Early school engagement and performance (preschool to year 3)	6.1
	6.1	Preschool and school attendance	6.2
	6.2	Year 3 literacy and numeracy	6.6
	6.3	Primary school children with dental caries	6.14
	6.4	Future directions in data	6.23
	6.5	References	6.24
7	Positive childhood and transition to adulthood	7.1
	7.1	Years 5 and 7 literacy and numeracy	7.3
	7.2	Retention at year 9	7.18
	7.3	Indigenous cultural studies in school curriculum and
	 	involvement of Indigenous people in development and
		delivery of Indigenous studies	7.20
	7.4	Juvenile diversions as a proportion of all juvenile offenders	7.28
	7.5	Transition from school to work	7.34
	7.6	Future directions in data	7.38
	7.7	References	7.39
8	Substance use and misuse	8.1
	8.1	Alcohol and tobacco consumption	8.2
	8.2	Alcohol related crime and hospital statistics	8.10
	8.3	Drug and other substance use	8.17
	8.4	Future directions in data	8.22
	8.5	References	8.23
9	Functional and resilient families and communities	9.1
	9.1	Children on care and protection orders	9.3
	9.2	Repeat offending	9.8
	9.3	Access to the nearest health professional	9.14
	9.4	Proportion of Indigenous people with access to their 
		traditional lands	9.22
	9.5	Participation in organised sport, arts or community group activities	9.27
	9.6	Future directions in data	9.33
	9.7	References	9.33
10	Effective environmental health systems	10.1
	10.1	Rates of diseases associated with poor environmental health	10.2
	10.2	Access to clean water and functional sewerage	10.9
	10.3	Overcrowding in housing	10.11
	10.4	Future directions in data	10.18
	10.5	References	10.19
11	Economic participation and development	11.1
	11.1	Employment by sector, industry and occupation	11.3
	11.2	CDEP participation	11.11
	11.3	Long term unemployment	11.15
	11.4	Self employment	11.17
	11.5	Indigenous owned or controlled land	11.20
	11.6	Accredited training in leadership, finance or management	11.30
	11.7	Case studies in governance arrangements	11.36
	11.8	Future directions in data	11.56
	11.9	References	11.57
Appendix 1 — COAG Communiqués	A1.1
Appendix 2 — Implementation by jurisdictions	A2.1
Appendix 3 — Composition of the Indigenous population	A3.1
Appendix 4 — Data limitations	A4.1

Acronyms and abbreviations
ABS	Australian Bureau of Statistics
ACER	Australian Council for Educational Research
ACT	Australian Capital Territory
AGD	Commonwealth Attorney-General’s Department
AHW	Aboriginal health worker
AIC	Australian Institute of Criminology
AIEW	Aboriginal and Islander Education Worker
AIHW	Australian Institute of Health and Welfare
AM	Member of Order of Australia
AMS	Aboriginal Medical Service
ANAO	Australian National Audit Office
ARIA	Accessibility and Remoteness Index of Australia
ATSIC	Aboriginal and Torres Strait Islander Commission
ATSIS	Aboriginal and Torres Strait Islander Services
Aust	Australia
CAEPR	Centre for Aboriginal Economic Policy Research
CAR	Council for Aboriginal Reconciliation
CCIG	Cherbourg Critical Incident Group
CDEP	Community Development Employment Projects
CDHFS	Commonwealth Department of Health and Family Services
CEO	Chief Executive Officer
CHINS	Community Housing and Infrastructure Survey
COAG	Council of Australian Governments
DEST	Department of Education, Science and Training
DEWR	Department of Employment and Workplace Relations
DHA	Department of Health and Ageing
DMFT	decayed, missing and filled teeth
DSRU	Dental Statistics and Research Unit
ERP	Estimated resident population
FTE	full time equivalent
GSA	Government of South Australia
GSS	General Social Survey
GWEH	Gross weekly equivalised household
Hib	Haemophilus influenza type b
HREOC	Human Rights and Equal Opportunity Commission
ICD	International classification of diseases
IEP	Indigenous Enterprise Partnerships
IESIP	Indigenous Education Strategic Initiatives Programme
ILC	Indigenous Land Corporation
ILUA	Indigenous Land Use Agreements
ISS	Indigenous Social Survey 
JJ NMDS	Juvenile Justice National Minimum Data Set
KHT	Koorie Heritage Trust
LAECG	Local Aboriginal Educational Consultative Group
LBOTE	language background other than English
LFS	Labour Force Survey
LSAY	Longitudinal Surveys of Australian Youth
MCATSIA	Ministerial Council for Aboriginal and Torres Strait Islander Affairs
MCEETYA	Ministerial Council on Education, Employment, Training and Youth Affairs
MOU	Memorandum of Understanding
NACCHO	National Aboriginal Community Controlled Health Organisation
NATSIS	National Aboriginal and Torres Strait Islander Survey
NATSISS	National Aboriginal and Torres Strait Islander Social Survey
NCVER	National Centre for Vocational Education Research
NDSHS	National Drug Strategy Household Survey
NHC	Nganampa Health Council
NHMP	National Homicide Monitoring Program
NHMRC	National Health and Medical Research Council
NIPC	National Indigenous Preschool Census
NNTT	National Native Title Tribunal
NSSC	National Schools Statistics Collection
NSW	New South Wales
NT	Northern Territory
NTDE	Northern Territory Department of Education
OECD	Organisation for Economic Cooperation and Development
PaL	Parents and Learning
PBS	Pharmaceutical Benefits Scheme
PISA	Program for International Student Assessment
POI	Persons of interest
QC	Queen’s Counsel
Qld	Queensland
RATEP	Remote Area Teacher Education Program
RCIADIC	Royal Commission Inquiry Into Aboriginal Deaths in Custody
Review	Review of Government Service Provision
RSE	Relative standard error
SA	South Australia
SACE	South Australian Certificate of Education
SCRGSP	Steering Committee for the Review of Government Service Provision
SIDS	Sudden Infant Death Syndrome
SPR	student progress rate
STI	sexually transmitted infections
TAFE	technical and further education
Tas	Tasmania
UEWI	unlawful entry with intent
UNICEF	United Nations Children’s Fund
VET	vocational education and training
Vic	Victoria
WA	Western Australia
WHO	World Health Organisation

Glossary
Age standardised rates	Age standardised rates enable comparisons to be made between populations which have different age structures. Where possible, direct standardisation is used, in which the age-specific rates are multiplied by a constant population. This effectively removes the influence of the age structure on the summary rate. Where populations are small, or where there is some uncertainty about the stability of age specific death rates, it is more appropriate to use indirect age standardisation. 	
CDEP	Community Development Employment Projects (CDEP) provide employment and training opportunities to Indigenous people in a range of activities that benefit themselves and their communities. The CDEP scheme comprises community determined and managed activities and organisations.	
Core activity restriction (ABS definition)	Self care, mobility and communication are defined as core activities. The ABS defines levels of core activity restriction as follows: mild, where a person has no difficulty with self care, mobility or communication, but uses aids or equipment; moderate, where a person does not need assistance, but has difficulty with self care, mobility or communication; severe, where a person sometimes needs assistance with self care, mobility or communication; and profound, where a person is unable to perform self care, mobility and/or communication tasks, or always needs assistance.	
Disability (ABS definition)	A person has a disability if he or she has a limitation, restriction or impairment, which has lasted, or is likely to last, for at least six months and restricts everyday activities. These activities include: loss of sight (not corrected by glasses or contact lenses); or an aid to assist with, or substitute for, hearing is used; speech difficulties; shortness	

	of breath or breathing difficulties causing restriction; chronic or recurrent pain or discomfort causing restriction; blackouts, fits, or loss of consciousness; difficulty learning or understanding; incomplete use of arms or fingers; difficulty gripping or holding things; incomplete use of feet or legs; nervous or emotional condition causing restriction; restriction in physical activities or in doing physical work; disfigurement or deformity; mental illness or condition requiring help or supervision; long-term effects of head injury, stroke or other brain damage causing restriction; receiving treatment or medication for any other long-term conditions or ailments and still restricted; or any other long‑term conditions resulting in a restriction.	
Geographic region	Geographic regions have been derived from the Australian Standard Geographic Classification of Remoteness, developed by the Australian Bureau of Statistics, and refer to the six remoteness area categories: 
•	major cities of Australia (consisting of the Census Collection Districts (CDs) with an average Accessibility/Remoteness Index of Australia (ARIA) index value of 0 to 0.2); 
•	inner regional Australia (consisting of the CDs with an average ARIA index value greater than 0.2 and less than or equal to 2.4);
•	outer regional Australia (consisting of the CDs with an average ARIA index value greater than 2.4 and less than or equal to 5.9); 
•	remote Australia (consisting of the CDs with an average ARIA index value greater than 5.9 and less than or equal to 10.5);
•	very remote Australia (consisting of the CDs with an average ARIA index value greater than 10.5); and 
•	migratory regions (consisting of off-shore, shipping and migratory CDs).	

Hospital separation	A hospital separation refers to an episode of care, which can be a total hospital stay (from admission to discharge, transfer or death), or a portion of a hospital stay beginning or ending in a change of type of care (for example, from acute to rehabilitation). It is also defined as the process by which an admitted patient completes an episode of care by being discharged, dying, transferring to another hospital or changing type of care. For measuring a hospital’s activity, separations are used in preference to admissions because diagnoses and procedures can be more accurately recorded at the end of a patient’s stay and patients may undergo more than one separation from the time of admission. Admitted patients who receive same day procedures (for example, renal dialysis) are recorded in separation statistics.	
Indigenous status not stated	Where either a Census form is not collected from people who have been identified during the collection process or where the Indigenous origin question is not answered. 	
Indigenous	A person of Aboriginal and/or Torres Strait Islander origin who identifies as an Aboriginal and/or Torres Strait Islander. 	
Non-Indigenous	A person who is not of Aboriginal and/or Torres Strait Islander origin. 	

Terms of Reference

	PRIME MINISTER

CANBERRA

		3 MAY 2002

Mr Gary Banks
Chairman
Steering Committee for the
	Review of Commonwealth/State Service Provision
C/‑ Productivity Commission
Locked Bag 2
Collins Street East Post Office
MELBOURNE   VIC   8003

Dear Mr Banks

I am writing in my capacity as Chairman of the Council of Australian Governments (COAG). As you would be aware, COAG met on 5 April 2002 and agreed to undertake further work to advance reconciliation. A copy of the communiqué from the recent COAG meeting is attached for your information.

COAG agreed to commission the Steering Committee for the Review of Commonwealth/State Service Provision (SCRCSSP) to produce a regular report to COAG against key indicators of indigenous disadvantage. The key task will be to identify indicators that are of relevance to all governments and indigenous stakeholders and that can demonstrate the impact of programme and policy interventions.

The development of the indicators will be progressed in the first instance through discussions at officials level between COAG, the Ministerial Council for Aboriginal and Torres Strait Islander Affairs (MCATSIA) and the SCRCSSP. I understand that the SCRCSSP proposed at its recent meeting to progress this matter through a working group that will include representatives of the COAG senior officials working group on reconciliation and MCATSIA officials. Such an approach is consistent with the COAG decision. 

In May 1997, I wrote to your predecessor, Mr Bill Scales, requesting that the SCRCSSP give particular attention to improving indigenous data. The development of the new COAG reconciliation report should not reduce the emphasis on indigenous data that is 
now a feature of the annual Report on Government Services. This emphasis has helped ensure that indigenous data in mainstream and targeted programmes are as comprehensive and comparable as possible.

I would appreciate further advice from you when the SCRCSSP has completed its work in developing a proposal for the report against indicators of indigenous disadvantage so that COAG members may consider the detail of the proposed approach.

I have copied this letter to the Chairman of MCATSIA and New South Wales Minister for Aboriginal Affairs, the Hon Dr Andrew Refshauge, and to the Minister for Immigration and Multicultural and Indigenous Affairs, the Hon Philip Ruddock MP.

Yours sincerely

Overview
This is the second Report in a series that has been prepared at the request of the Council of Australian Governments. It aims to provide indicators of Indigenous disadvantage ‘that are of relevance to all governments and Indigenous stakeholders, and that can demonstrate the impact of programme and policy interventions’ (see pp.xvi–xvii). Like the first Report, the focus is on those areas in which governments have the greatest capacity to change things for the better in the short and long term. It is wide ranging in the scope of its reporting and has, as a fundamental premise, that prevention is a far better strategy for reducing disadvantage than ‘fixing up’. 
Has anything changed?
In reflecting on the first Report at its release in November 2003, the Steering Committee’s Chairman, Gary Banks, said that the results confirmed the pervasiveness of Indigenous disadvantage. He went on to observe:
It is distressingly apparent that many years of policy effort have not delivered desired outcomes; indeed in some important respects the circumstances of Indigenous people appear to have deteriorated or regressed. Worse than that, outcomes in the strategic areas identified as critical to overcoming disadvantage in the long term remain well short of what is needed.
Eighteen months on, this Report reveals mixed results — in some areas it is able to show improvements, while in others there appears to have been no change or some slippage. However, caution is needed in making comparisons from some data. Whereas a significant amount of data in the 2003 Report were drawn from the Australian Bureau of Statistics’ (ABS) 2001 Census, the 2005 Report has relied largely on the ABS’s 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) results. The results from these two data collections are not comparable.
That said, it is possible to identify some significant areas of improvement.
Among the economic indicators: 
•	between 1994 and 2002 there were improvements in labour force participation, unemployment, employment and home ownership;
while in the social indicators:
•	between 1994 and 2002 there were improvements in post-secondary education participation and attainment, and between 2000 and 2004 in apparent retention rates to year 12, and
•	there has been a trend upwards from 1999 to 2002 in achievement against the year 3 writing benchmark.
Areas where outcomes appear to have weakened are:
•	victim rates for crime between 1994 and 2002
•	from 1999-2000 to 2003-04 for substantiated child protection notifications, and
•	imprisonment rates for both men and women, over the period 2000 to 2004.
Many of the indicators show little or no movement. A large gap between Indigenous people and the rest of the population is apparent in all of the headline indicators and most of the strategic change indicators, including those where there has been some improvement. 
It is important to note, however, that much of the information, for example the 2002 NATSISS data, comes from a period prior to the adoption of the framework by governments. As such, any outcomes from more recent government interventions would not be showing up as yet. As a rule, the more recent administrative data are also more amenable to comparison, although care needs to be taken in interpreting trends, given the relatively short span of time between the two reports and the identification issues.
Despite these reservations, due to the rich source of data that have been provided by the NATSISS, this Report includes information that could not be reported in 2003, for example, disability and participation in sport, arts and community group activities; while reporting against other indicators (such as ‘access to health professionals’) has been expanded to reflect the importance of primary health care.
Of course it remains true that not everything can get captured in national data. Where improvements are occurring at a community level, for instance, they will not necessarily show up in State or national data. For that reason, more case studies and boxes on ‘things that work’ have been included in the 2005 Report to provide some indication of the variety of initiatives that are making a difference in many Indigenous communities. Some of these initiatives are producing significant outcomes and serve to demonstrate to both Indigenous communities and governments what might be successful elsewhere. 
How many people
In the 2001 census, 410 000 people identified themselves as Indigenous out of a total population of nearly 19 million people. Thirty per cent of Indigenous people lived in major cities, 20 per cent in inner regional areas, and 23 per cent in outer regional areas, while 9 per cent lived in remote areas and 18 per cent lived in very remote areas. Less than 1 per cent of the Indigenous population were migratory (see appendix 3). 
Consultations
Prior to the release of the first Report in 2003, an extensive consultation process took place. The primary purpose of those consultations was to get input to assist in development of the framework. The Australian, State and Territory governments conducted consultations with Indigenous groups and service providers within their jurisdictions. In addition, the Chairman and Secretariat held discussions with a number of Indigenous leaders and organisations, and a range of officials and researchers across the country. 
Following release of the Report consultations continued, to obtain feedback about the Report from Indigenous organisations and people, and from governments, on how they are using and implementing it. For the most part, such feedback was positive. The reasoning behind the framework and its diagrammatic representation meant that it was easily explained and generally understood (and broadly accepted) by stakeholders.
Culture
The issue most often raised during consultations was whether cultural dimensions of Indigenous wellbeing could be better represented. While there have been no changes to the framework in this Report, it is an area that will need to be revisited in future reports. Nevertheless, reporting on culture has improved over what was reported in 2003. Along with more data and case studies for the key indicators relating to ‘Indigenous cultural studies in school curriculum’, ‘participation in organised sport, arts or community group activities’, and ‘access to traditional lands’, the section containing case studies in governance recognises the fundamental importance of culture in the development of good governance arrangements in Indigenous organisations and communities. The two case studies presented — on the Thamarrurr Council in Wadeye in the Northern Territory and the Koorie Heritage Trust in Victoria — both demonstrate (in different ways) the significance of culture in their organisational arrangements and the relationship to their respective communities.
The reporting framework
Figure 1: The framework
	
The Report’s indicator framework is depicted in figure 1. At its apex are three ‘priority outcomes’. They reflect a vision for how life should be for Indigenous people that is shared by governments and Indigenous people alike. The outcomes are linked and should not be viewed in isolation from each other. The extent to which these outcomes are being achieved is indicated through the headline indicators. Given their nature, these could not be expected to change rapidly, or in response to individual policy measures.
Sitting beneath the priority outcomes and headline indicators are seven ‘strategic areas for action’. These are areas where governments and Indigenous people, working together, could potentially make a difference in the shorter term. Each strategic area for action is linked to a set of strategic change indicators. These indicators are designed to tell us where we are making a difference, and alert us to where more attention is needed.
The goal is that improvements in the strategic areas for action will, in time, make it possible to overcome the sources of disadvantage which currently lead the circumstances of many Indigenous people and communities to fall short of the priority outcomes. 
Headline indicators
The first part of the Report focuses on the headline indicators — measures of the major social and economic factors that need to improve if COAG’s vision of an Australia in which Indigenous people come to enjoy the same overall standard of living as other Australians, is to be achieved. These are set out below.

HEADLINE INDICATORS	
•	Life expectancy at birth
•	Rates of disability and/or core activity limitation
•	Years 10 and 12 retention and attainment
•	Post secondary education — participation and attainment
•	Labour force participation and unemployment
•	Household and individual income
•	Home ownership
•	Suicide and self-harm
•	Substantiated child protection notifications
•	Deaths from homicide and hospitalisations for assault
•	Victim rates for crime
•	Imprisonment and juvenile detention rates	
	
	Some key messages arising out of the data in each area are also included, with references to where more information can be found in the main Report.
Life expectancy at birth
This indicator refers to the average number of years a person could expect to live if there was no change to the population’s death rates throughout his or her lifetime.
Life expectancy is an indicator of the long-term health and wellbeing of Indigenous Australians. Among the many factors which can have an influence on life expectancy are levels of income and education, and environmental issues such as lack of clean drinking water or adequate sanitation, which can accentuate health risks, particularly for infants and young children. Other factors which can contribute to lower life expectancy are consumption of tobacco and excessive alcohol, poor nutrition and lack of exercise, to the extent that these are widespread phenomena within the community.

Box 1.1	KEY MESSAGES
•	On the basis of revised data sets, the life expectancy of Indigenous people is estimated to be around 17 years lower than that for the total Australian population (figure 3.1.1).
•	The most recent estimates on a comparable basis indicate that life expectancy at birth is 59 years for Indigenous males compared with 77 years for males in the total population, and 65 years for Indigenous females compared with 82 years for females in the total population (figure 3.1.1).	
	
	Rates of disability and/or core activity restriction
This indicator reports on two measures of disability based on results from the 2002 NATSISS. The first provides information on the number of Indigenous people 15 years and over who identified as having a disability. 
The second measure provides information on those Indigenous people who reported having a disability which resulted in a core activity limitation. The level of core activity limitation may be profound (always needs help or supervision); severe (sometimes needs help or supervision); moderate (has difficulty but does not need assistance); or mild (uses aids to assist with core activities).
Also provided is information on Indigenous people who were admitted to hospital due to injuries or illnesses which may lead to disability or disabling conditions.

Box 1.2	KEY MESSAGES
•	The proportion of the Indigenous population 15 years and over, reporting a disability or long-term health condition was 37 per cent (102 900 people). The proportions were similar in remote and non-remote areas. This measure of disability does not specifically include people with a psychological disability (figures 3.2.1 and 3.2.2, table 3A.2.1).
•	The proportion of the Indigenous population aged 18 years and over in non-remote areas reporting a disability (including psychological) was 49 per cent, one-third of whom (17 per cent) had a core activity limitation (table 3A.2.4, figure 3.2.4).
•	After adjusting for age differences, Indigenous people over 18 years in non-remote areas were 1.7 times more likely than non-Indigenous people to report a disability resulting in a core activity limitation (figure 3.2.6).	
	
	Years 10 and 12 retention and attainment
Students who stay on at school and complete year 12 are much more likely to undertake additional education and training. In turn, they will have more, and better, employment options. 
In the long term, people who have completed secondary or post secondary education are more likely to encourage their children to do the same, so that the benefits can flow from one generation to another. 
There has been success in increasing retention rates for Indigenous students in some schools where special programs have been introduced. A greater recognition of Indigenous culture can be an important element in giving students the skills and knowledge they need to ‘walk in two worlds’.

Box 1.3	KEY MESSAGES
•	From 2000 to 2004, Indigenous apparent retention rates to year 12 increased from 36 per cent to 40 per cent (figure 3.3.1). 
•	Nationally in 2004, Indigenous students were half as likely to continue to year 12 as non-Indigenous students (figure 3.3.3).
•	Nationally, the proportion of Indigenous students who had commenced year 11 in the previous year who achieved a year 12 certificate increased from 49 per cent in 2001 to 55 per cent in 2002 (tables 3A.3.6 and 3A.3.7).	
	
	Post secondary education — participation and attainment
People who have participated in post secondary study have greatly improved employment prospects. They are also more likely to earn higher incomes from their work. 
This indicator examines participation at universities, as well as institutes of technical and further education (TAFE). Attending a tertiary institution in itself may not lead to improved employment opportunities and higher income earning capacity. Participation generally needs to be accompanied by success — the attainment or completion of a course of study.
Positive outcomes in virtually all of the strategic areas for action could contribute to better educational achievement.

Box 1.4	KEY MESSAGES
•	The proportion of Indigenous people 15 years and over participating in post secondary education increased from around 6 per cent in 1994 to 12 per cent in 2002 (table 3A.4.4).
•	From 1994 to 2002, the proportion of Indigenous people with a certificate level 3 or above doubled (8 per cent in 1994 to 16 per cent in 2002) (figure 3.4.3).	
	
	Labour force participation and unemployment
Having a job that pays adequately and provides opportunities for self development is important to most people. 
It is important to the individual in terms of living standards and self-esteem, and overall wellbeing. It is important also to the family. Children who have a parent who is employed are more likely to attend school and stay on past the compulsory school age. They are also more likely to enter into post secondary education and gain employment.
Unemployment can have a major impact on a number of areas covered in this Report, including poor health and mortality, domestic violence, homelessness and substance misuse.
The labour force participation rate will, to some extent, reflect the limited employment opportunities available to Indigenous people in remote areas, along with the employment opportunities provided by CDEP (that is, measured employment is generally higher in areas where there are CDEP opportunities).

Box 1.5	KEY MESSAGES
•	Nationally, the labour force participation rate for Indigenous people aged 18 to 64 years has increased from 57 per cent in 1994 to 64 per cent in 2002 (figure 3.5.2).
•	From 1994 to 2002 there have been large falls in the Indigenous unemployment rate. Nationally the rate fell from 30 per cent to 20 per cent (figure 3.5.5).
•	The age standardised labour force participation rate for Indigenous people in 2002 was just over three quarters of that for non-Indigenous people (figure 3.5.1).
•	The age standardised unemployment rate in 2002 was 3.2 times higher for Indigenous than for non-Indigenous people (figure 3.5.4). 
•	There were over 36 000 CDEP participants at 30 June 2004. CDEP participation significantly reduces recorded Indigenous unemployment rates.	
	
	Household and individual income
The economic wellbeing of individuals is largely determined by their income and wealth. The extent to which income for Indigenous people is lower than for non-Indigenous people, is a major indicator of differences in material wealth.
By extension, income is also linked to overall wellbeing. Higher income can enable the purchase of better food, housing, recreation and health care. There may also be psychological benefits such as a greater sense of control and self-esteem. Low income can be both a cause and an effect of disadvantage. For example, people with health problems caused by low income may be limited in their ability to work and increase their incomes.

Box 1.6	KEY MESSAGES
•	In 1994 real gross weekly equivalised household income for Indigenous people was $374, and in 2002 it was $394 (figure 3.6.2).
•	In 2002, both household and individual incomes were lower on average for Indigenous than other people (figures 3.6.1 and 3.6.4).	
	
	Home ownership
Home ownership is an important economic indicator of wealth and saving, and is likely to be positively related to employment and income indicators. Home ownership provides a secure asset base that can contribute to financial stability and against which people can borrow.
As the consultations revealed, not all Indigenous people aspire to home ownership, especially those in more remote areas and living more traditional lifestyles. Others said home ownership was an important element in improving Indigenous wellbeing. And some Indigenous people said that home ownership was important to them as a tangible connection to the land. 

Box 1.7	KEY MESSAGES
•	The proportion of Indigenous people aged 18 years and over who were living in a home that someone in their household owned or was purchasing, increased from 22 per cent to 27 per cent between 1994 and 2002 (figure 3.7.3).
•	Nationally in 2002, a much lower proportion of Indigenous people (27 per cent) than non-Indigenous people (74 per cent) lived in homes someone in their household owned or was purchasing (figures 3.7.1 and 3.7.2).	
	
	Suicide and self-harm
Suicide rates are higher for Indigenous people than other Australians, and particularly for those aged 25 to 34.
Research suggests that Indigenous suicide and self-harm are most common among young men. They are generally associated with alcohol and substance misuse, and interpersonal conflicts (although only 15 per cent of Indigenous people report consuming alcohol at a risky level). Other factors are incarceration, violence and family breakdown. Anxiety and depression are major contributors, particularly among young Indigenous people.

Box 1.8	KEY MESSAGES
•	Suicide death rates were much higher for Indigenous people (between 12 and 36 per 100 000 people) than other people (between 11 and 16 per 100 000 people) in 1999–2003, in most states and territories for which data are available (figure 3.8.2).
•	Between 2001-02 and 2002-03, the age standardised hospital separation rate (admissions) for intentional self-harm increased for Indigenous people from 2.8 to 3.2 per 1000 people, while it remained the same for other people (table 3A.8.4).	
	
	Substantiated child protection notifications
Many Indigenous families and communities live under severe social strain due to a range of socioeconomic factors. Alcohol and substance misuse, and overcrowded living conditions are just some of the factors which can lead to child abuse and violence.
This indicator provides some indication of the extent of abuse, neglect and/or harm to children in the family environment. 
The substantiation data refer only to those matters which have been notified and investigated. No credible data exist on actual levels of abuse.

Box 1.9	KEY MESSAGES
•	From 1999-2000 to 2003-04 the number of substantiations per 1000 Indigenous children increased in most jurisdictions (table 3A.9.1).
•	The rate of children who were subject to substantiated notification was higher for Indigenous than other children in most jurisdictions (table 3A.9.1).	
	
	With the cooperation of governments, some Indigenous communities have been successful in developing strategies which have resulted in a marked decline in child abuse. 
Deaths from homicide and hospitalisations for assault
The impact of homicide and hospitalisations for assault extends beyond the offender and immediate victim. Families are severely affected, as are the communities in which they live, and the impact may be felt from one generation to another.
Indigenous homicides tend to involve family members, with disputes within families being one of the main factors. Most Indigenous homicide victims are aged between 25 and 44.
Indigenous homicides and assaults are frequently connected with alcohol consumption. A much larger share of Indigenous homicides involved both the offender and victim having consumed alcohol at the time of the offence, compared with non-Indigenous homicides.

Box 1.10	KEY MESSAGES
•	In the period 1999 to 2003, in the five jurisdictions for which data are available, homicide death rates for Indigenous people (6 to 23 per 100 000) were at least six times higher than those for other Australians (1 to 3 per 100 000) (figure 3.10.1).
•	Nationally in 2002-03, Indigenous people were more than 12 times as likely to be hospitalised for assault as non-Indigenous people (figure 3.10.5 and table 3A.10.9).	
	
	Apart from ‘substance use and misuse’, actions in a number of the other strategic areas also have the potential to make a difference by addressing the socioeconomic circumstances which can lead to dysfunctional families and violent behaviour.
Victim rates for crime
Socioeconomic factors are critical determinants of crime. Unemployment, low income, housing overcrowding and substance misuse, are all factors which can lead to violence, particularly in the home.
The Royal Commission into Aboriginal Deaths in Custody recognised that family violence was a major reason for men being in prison. Whereas the focus has often been on how these factors influence the perpetrators of crime, they are just as important when it comes to the victims. 
Community-based projects that are run by Indigenous people have been started in a number of places. 
•	One example in the Northern Territory which is being trialled is family focussed, with the belief that stronger families empower communities to deal with social issues.
•	Another example in NSW is the ‘BLACKOUT Violence’ campaign which unites Aboriginal and non-Aboriginal services to address the impacts of violence within inner city and regional Aboriginal communities.

Box 1.11	KEY MESSAGES	
•	The proportion of Indigenous people who reported being a victim of violence increased from 13 per cent to 23 per cent between 1994 and 2002 (table 3A.11.3).
•	After adjusting for age differences between populations, both Indigenous women and men experienced more than double the victimisation rates of other women and men in 2002 (table 3A.11.2). 	
	
	Imprisonment and juvenile detention rates
Over-representation of Indigenous people in the criminal justice system is well documented. Many factors create the conditions which result in Indigenous incarceration. One highly significant factor is that the early involvement of young people in the criminal justice system puts them at much higher risk of being imprisoned as adults.
There is a range of social and economic factors which can be determinants of the high representation of Indigenous people in the criminal justice system. 

Box 1.12	KEY MESSAGES
•	There has been no improvement in imprisonment rates between 2000 and 2004. Over this period, Indigenous women’s imprisonment increased by 25 per cent and that for Indigenous men by 11 per cent (figure 3.12.1).
•	On 30 June 2004, the most serious offence of around one quarter of all sentenced prisoners was ‘acts intended to cause injury’ (figure 3.12.3). 
•	After adjusting for age differences, Indigenous people were 11 times more likely than other Australians to be imprisoned (table 3.12.1). 
•	Indigenous juveniles were 20 times more likely to be detained than other juveniles on 30 June 2003 (figure 3.12.4).	

STRATEGIC AREAS FOR ACTION
This second part of the Report is concerned with the strategic areas for action and provides information on the strategic change indicators. These have been chosen for their potential to have a significant and lasting impact in reducing Indigenous disadvantage. Some key messages arising out of the data in each area are also included, with references to where more information can be found in the main Report.
Strategic areas for action	Strategic change indicators	
Early child development and growth
(prenatal to age 3)	•	Rates of hospital admission for infectious diseases
•	Infant mortality
•	Birthweight
•	Hearing impediments	
Early school engagement and performance
(preschool to year 3)	•	Preschool and school attendance
•	Year 3 literacy and numeracy
•	Primary school children with dental caries	
Positive childhood and transition to adulthood	•	Years 5 and 7 literacy and numeracy
•	Retention at year 9
•	Indigenous cultural studies in school curriculum and involvement of Indigenous people in development and delivery of Indigenous studies
•	Juvenile diversions as a proportion of all juvenile offenders
•	Transition from school to work	

Substance use and misuse	•	Alcohol and tobacco consumption
•	Alcohol related crime and hospital statistics
•	Drug and other substance use	

Strategic areas for action	Strategic change indicators	
Functional and resilient families and communities	•	Children in care and protection orders
•	Repeat offending
•	Access to the nearest health professional
•	Proportion of Indigenous people with access to their traditional lands
•	Participation in organised sport, arts or community group activities	
Effective environmental health systems	•	Rates of diseases associated with poor environmental health (including water and food borne diseases, trachoma, tuberculosis and rheumatic heart disease)
•	Access to clean water and functional sewerage
•	Overcrowding in housing	
Economic participation and development	•	Employment (full-time/part-time) by sector (public/private), industry and occupation
•	CDEP participation
•	Long term unemployment
•	Self employment
•	Indigenous owned or controlled land
•	Accredited training in leadership, finance or management
•	Case studies in governance arrangements	
Early child development and growth (prenatal to age 3)
These are critical years. Providing a child with a good start in life can have a profound effect on their progression through the life cycle. Health and educational outcomes in later life are greatly influenced by the health, growth and development of children in their first three years of life.
A wide range of social, cultural, physical and economic factors can influence the health of children. It is in these early years that they are most vulnerable and where policy action can lead to improvements in the longer term.
Rates of hospital admission for infectious diseases
Infectious diseases range in severity from minor conditions such as the common cold, to serious illnesses such as meningococcal infection and tuberculosis. Some infections that may appear minor can have serious longer term health effects. For example, recurring skin infections such as impetigo (school sores) in some Indigenous communities are linked to acute rheumatic fever.
Most childhood diseases are generally successfully prevented or treated. This indicator examines those infectious diseases which result in children being hospitalised.

Box 1.13	KEY MESSAGE
In 2002-03, the hospital separation rate (admissions) for Indigenous children aged less than four years for infectious diseases (111 per 1000 people) was more than twice the rate for other children (48 per 1000 people) (table 5.1.1).	
	
	Infant mortality
The survival of infants in their first year of life is commonly viewed as an indicator of the general health and wellbeing of a population.
While there has been a dramatic decline in infant mortality rates in the past century for all Australians, the mortality rate for Indigenous infants is still significantly higher than for infants in the rest of the population.
The main causes of Indigenous infant deaths are congenital disorders, Sudden Infant Death Syndrome, respiratory and cardiovascular disorders and accidents.

Box 1.14	KEY MESSAGE	
Indigenous infant mortality rates in states and territories for which data are available have slightly improved (in some jurisdictions) in recent years. Nevertheless, infant mortality rates for Indigenous Australians in these jurisdictions were two to three times as high as those for the total population (table 5.2.1).	
	
	Birthweight
Infants with a low birthweight are more likely to die or have problems early in life. Low birthweight may also have an influence on the development of chronic diseases in adulthood, including diabetes and heart disease.
The birthweight data used in this Report relate only to babies born to Indigenous mothers.

Box 1.15	KEY MESSAGE
The proportion of live births during 1999–2001 with low through to extremely low birthweight was more than twice as high for babies born to Indigenous mothers than for babies born to non-Indigenous mothers (table 5.3.2).	
	
	Hearing impediments
Otitis media, the main cause of hearing problem faced by Indigenous children, is characterised by very early onset, persistence and high rates of severity. It can become a chronic disease which Indigenous people carry from childhood into adolescence. 
Hearing impediments, if untreated when children are young, may affect their attendance at school, and their capacity to learn and socialise. Accordingly, hearing impediments can have a substantial impact on the future of Indigenous children.

Box 1.16	KEY MESSAGES	
•	Due to data deficiencies, particularly for the age category 0–3 years, it is difficult to assess nationally the level of ear infections and the extent of hearing loss across Indigenous and non-Indigenous populations.
•	In 2002-03, hospital separations (admissions) for suppurative and unspecified otitis media were higher for Indigenous children aged 0–3 years (5 per 1000) than other children in this age group (4 per 1000) (table 5.4.1).	
	
	Early school engagement and performance (preschool to year 3)
The extent to which Indigenous children begin formal learning at an early age, attend school regularly, and are healthy, safe and supported by their families and communities, all have a bearing on educational outcomes in the short and long term.
Research shows that the children most likely to have learning difficulties often have nutritional, hearing or other health problems. Poor dental health can cause impaired speech and language development.
Preschool and school attendance
Early participation in education provides young children with opportunities to develop socially and may also have a significant bearing on their future educational performance. All the strategic areas have some relevance to achieving good outcomes for young children in education. In particular, parental support in ensuring that young children attend school regularly is very important. 
Unfortunately, there are no data available on attendance for the period from preschool to year 3. Participation rates only indicate the number of children enrolled as a proportion of the population group. 

Box 1.17	KEY MESSAGE
In 2003, national school participation rates for Indigenous five to eight year old children was 87 per cent compared to 93 per cent for non-Indigenous children of the same age (figure 6.1.1, table 6A.1.3).	
	
	Year 3 literacy and numeracy
The level of achievement in the early years of schooling has major implications for retention and attainment in later years. Children who have already fallen behind in year 3 will have difficulty in progressing through school and are less likely to remain at school beyond the compulsory age. This in turn has implications for employment options and disadvantage in the long term.
Support for Indigenous parents who may themselves have limited education, is a key factor in ensuring that their children are encouraged to do well at school. The Parents and Learning Program (PaL), which has been operating for four years in the Napranum community in Cape York, has resulted in positive outcomes for children and their parents.

Box 1.18	KEY MESSAGES	
•	There was an increase in the proportion of year 3 Indigenous students who achieved the writing benchmark in 2002 (77 per cent), compared to 67 per cent in 1999 and 65 per cent in 2000 (figure 6.2.5).
•	Year 3 Indigenous students in 2002 had significantly lower reading, writing and numeracy achievements than year 3 students overall (figure 6.2.1).	
	
	Primary school children with dental caries
Unless treated early, tooth decay may result in pain, infection and destruction of soft tissue in the mouth. School attendance and performance may be affected.
Decayed teeth can cause or contribute to low self-esteem and social wellbeing. Employment and interpersonal relations may be affected. The loss of permanent teeth can lead to eating difficulties along with social isolation.

Box 1.19	KEY MESSAGES
•	Indigenous children aged 4–12 years on average had a higher number of teeth with decay than other children where data are available in 2000 (table 6.3.1).
•	The proportion of children in need of immediate treatment was also much higher for Indigenous than non-Indigenous children where data are available in 2000 (figure 6.3.1).	
	
	Positive childhood and transition to adulthood
The later years of childhood, adolescence and the transition to adulthood are important phases which build upon early child development and education.
What happens in these years can have far reaching consequences. Good educational outcomes for young Indigenous people will enhance their opportunities as adults. Avoiding the criminal justice system may deter them from subsequent imprisonment and a cycle of re-offending.
Years 5 and 7 literacy and numeracy
Research has shown that achievement in years 5 and 7 literacy and numeracy is a key determinant of whether children go on to year 12 and higher education. The lack of basic literacy and numeracy skills also results in poor employment prospects.
Other research has found that low literacy is one of the biggest hurdles to be overcome in improving the health of Indigenous people.

Box 1.20	KEY MESSAGES	
•	The proportion of year 5 Indigenous students who achieved the reading benchmark increased steadily from 59 per cent in 1999 to 68 per cent in 2002, whereas the proportion remained relatively stable for all students (figure 7.1.3).
•	In 2002, the proportion of Indigenous students who achieved the year 5 and 7 reading, writing and numeracy benchmarks was lower than that for all students, (figures 7.1.1 and 7.1.8).	
	
	Retention at year 9
For most students, compulsory schooling ends during years 9 and 10. Consultations with Indigenous people revealed that this was a critical time for Indigenous children. Many of those who leave have poor literacy and numeracy skills and this limits their post-school options, including employment opportunities.
Although the data suggest only a two per cent gap between Indigenous and non-Indigenous students, because these data are collected mid-way through the year, they do not reflect the number of children who failed to complete the year.

Box 1.21	KEY MESSAGES
•	Over the period 2000 to 2004, the Indigenous retention rate to year 9 was relatively stable (figure 3.3.1).
•	In 2003, the retention rate for Indigenous students to year 9 was 97 per cent. In 2004, the retention rate for the same group of students (now in year 10) had declined by 11 percentage points to 86 per cent (figure 3.3.1).	
	
	Indigenous cultural studies in school curriculum and involvement of Indigenous people in their development and delivery
The inclusion of Indigenous cultural studies in school curricula is widely regarded (by both Indigenous and non-Indigenous people) as being an important factor in an Indigenous student’s self-esteem and achievement at school. It is important also in increasing the understanding and acceptance of Indigenous people in the wider community. The participation of Indigenous people in the development and delivery of cultural studies is also regarded as highly desirable.

Box 1.22	KEY MESSAGES
•	Some schools (primary and secondary) are incorporating Indigenous languages, culture, history and civics programs into their curricula — to improve education outcomes for Indigenous students and to improve all students’ knowledge and appreciation of Indigenous people and their culture.
•	In 2003, Indigenous teachers and education workers generally comprised a much smaller proportion of school staff than the proportion of Indigenous students (table 7.3.1). 	
	
	Juvenile ‘diversions’
In some jurisdictions there are diversion programs which allow a young offender to be dealt with outside the traditional court processes. This might involve, for example, a caution or attendance at community and family conferences. Programs vary from one State to another. Diversionary mechanisms in combination with sports and leisure programs can contribute to a reduction in antisocial behaviour and offending.
There are no national data on the extent of juvenile diversions. This section of the Report presents (non-comparable) data from NSW, Victoria, WA, SA and the NT.

Box 1.23	KEY MESSAGE	
Although data on juvenile diversions are not comparable between states and territories, a smaller proportion of Indigenous juveniles are diverted than is generally the case for other juveniles.	
	
	Transition from school to work
Two approaches are used to analyse the period of transition from school to work. The first is the ‘at risk’ approach, which examines the proportion of people aged 18–24 who are neither in employment nor engaged in study. These people are considered to be ‘at risk’ of long term disadvantage. The second approach looks at outcomes from education.

Box 1.24	KEY MESSAGES	
•	In 2002, 42 per cent of Indigenous people aged 18–24 years were neither studying nor employed or in the labour force, compared with 13 per cent of other Australians (figure 7.5.1). 
•	An education attainment of certificate level 3 or above significantly reduced an Indigenous person’s chance of being unemployed (table 7.5.1).	
	
	Substance use and misuse
Substance use and, particularly, misuse have the capacity to impact on every aspect of a person’s life. A range of social factors can influence the misuse of substances, such as socioeconomic status, unemployment and poor education. Impacts can have far reaching effects on a person’s quality of life and health, and on those around them. The end result may be a reduction in life expectancy.
Alcohol and tobacco consumption
Cigarette smoking and excessive alcohol consumption are associated with increased illness and morbidity. Apart from the health risks to the individual, high levels of alcohol consumption also contribute to domestic violence, financial problems, child abuse and family breakdowns. In the case of pregnant women, it can also adversely affect the health of new born infants.

Box 1.25	KEY MESSAGES
In 2002:
•	Over half (51 per cent) of Indigenous people aged 15 years and over were cigarette smokers (table 8.1.1.); the rates for both Indigenous men and women in all age groups were similar to those in 1994 (figures 8.1.3 and 8.1.4).
•	Around 15 per cent of Indigenous people reported risky alcohol consumption; the rate was higher for Indigenous men (17 per cent) than for Indigenous women (13 per cent) (table 8A.1.4).
•	Indigenous people living in remote areas were less likely to consume alcohol (54 per cent) than those in non‑remote areas (75 per cent), but the levels of risky alcohol consumption in remote and non‑remote areas were similar (table 8.1.3).	
	
	Alcohol related crime and hospital statistics
There is a strong association between alcohol and violence, crime and anti-social behaviour. Alcohol consumption can also have many health consequences such as liver cirrhosis, mental illness, cancer, pancreatitis and damage to the foetus among pregnant women.
There are no reliable data on the overall extent of alcohol related crime. Data from police records on alcohol related homicides have been used. Hospital data are also very limited and deal only with admissions to hospital for alcohol related illnesses.

Box 1.26	KEY MESSAGES
•	In 2002-03, 65 per cent of Indigenous homicides involved both the victim and offender having consumed alcohol at the time of the offence — almost three times the rate for non-Indigenous homicides (figure 8.2.1).
•	In 2002-03, Indigenous people (both males and females) were more than four times as likely to be in hospital for alcohol-related mental and behavioural disorders than other people.	
	
	Drug and other substance use
Reducing drug-related harm will improve health, social and economic outcomes at both the individual and community level. Illicit drug consumption has played a major role in the involvement of Indigenous people in the criminal justice system. There is a strong connection between domestic violence and drug and alcohol use in Indigenous communities. The use of substances such as inhalants (for example, petrol and glue) can lead to long-term brain damage, disability or even death.

Box 1.27	KEY MESSAGES
•	In 2002, nearly 40 per cent of non-remote Indigenous people had used substances at some time in their lives while 24 per cent had used substances in the previous 12 months (table 8A.3.1).
•	The most common conditions for drug-related hospital separations (admissions) were mental and behavioural disorders, poisoning and accidental poisoning (table 8A.3.1).	
	
	Functional and resilient families and communities 
Families and communities are the mainstay of our society. The extent to which they are functional and resilient will have a direct impact on a range of outcomes for Indigenous people. A caring, protective and supportive environment where there are positive health outcomes and cultural awareness are some of the characteristics that are important.
Dysfunctional families and communities can lead to breakdown in relationships and social alienation, physical and mental health problems, amongst others. Ultimately, outcomes in life expectancy, education, imprisonment, violence, employment and income can be affected.
Children on care and protection orders
Data on children under care and protection orders show the extent to which some form of legal intervention has been made for their protection. Given that legal intervention is usually a last resort, after other interventions have failed or have proven infeasible, this may provide some indication of the social and cultural stress under which many people in Indigenous communities live.
Not all orders are due to neglect and abuse — in some cases, family difficulties such as a parent being hospitalised or dying may be the reason why a child is placed in care.

Box 1.28	KEY MESSAGE
The rate of children on care and protection orders (for a combination of all states and territories except NSW) was five times higher for Indigenous children (20 per 1000 children in the population aged 0–17 years) than for non-Indigenous children (4 per 1000 children) (table 9.1.1).	
	
NSW could not provide substantiation data for 2003-04 due to the implementation of a new system.
Repeat offending
The cycle of Indigenous imprisonment has severe impacts on families and communities, both in the short and long term. Cycles of intergenerational offending, where children of prisoners commit offences that result in their own imprisonment, is common for Indigenous families. It is important that people who have contact with the criminal justice system have the ability and opportunity to integrate back into the community, lead productive lives, and not re-offend. 
The introduction of special courts – for example, the Koori Court in Victoria, the Murri Court in Queensland and the NSW Circle Sentencing Court – has resulted in a reduction in re-offending.

Box 1.29	KEY MESSAGES
•	Nationally, there was no improvement between 2000 to 2004 in the proportion of Indigenous prisoners experiencing prior adult imprisonment (figure 9.2.2). 
•	On 30 June 2004, around four in five Indigenous prisoners had previously been in prison (figure 9.2.2). 	
	
	Access to the nearest health professional
Access to health services is important in identifying and treating diseases in a timely way. A consequence of lack of access is the high prevalence of diseases such as diabetes and pulmonary diseases. Many such chronic conditions are potentially preventable if treated early. Vaccination can also be effective in the prevention of diseases such as influenza and pneumococcal disease.

Box 1.30	KEY MESSAGE
Indigenous people suffer from markedly higher rates of potentially preventable chronic health conditions than the rest of the population. Hospital separation rates (admissions) for diabetes complications were 8 times higher, and for pulmonary disease 4 times higher than for other Australians (table 9.3.1).	
	
	Proportion of Indigenous people with access to their traditional lands
Land is important to Indigenous people both culturally and economically. The aim of this indicator is to show the extent to which Indigenous people have access to their traditional lands. Data for this indicator are based on three items in the ABS 2002 NATSISS, which asked people about:
•	recognition of their homelands/traditional country
•	whether they currently were living on homelands
•	whether they were allowed to visit their homelands.

Box 1.31	KEY MESSAGES
•	In 2002, 70 per cent of Indigenous people recognised an area as their homelands or traditional country; 22 per cent lived on their homelands, whereas 47 per cent did not live there but were allowed to visit (figure 9.4.1).
•	Indigenous people in very remote areas were more likely than those in other areas to live on their homelands (figure 9.4.1).	
	
	Participation in organised sport, arts or community group activities
Taking part in organised sport, arts or community group activities can foster self-esteem, social interaction, and the development of skills and teamwork.
Some of the benefits that might result from early participation in these activities are stronger bodies, the prevention of chronic diseases and improved learning and academic performance. A reduction in substance misuse, self-harm, and crime may also result.

Box 1.32	KEY MESSAGE
Around half of Australia’s Indigenous people aged 15 years and over participated in organised sport or physical activity in the three months prior to the ABS 2002 National Aboriginal and Torres Strait Islander Social Survey (table 9.5.2).	
	
	Effective environmental health systems 
The conditions in which people live and work have a major influence on their health. Environmental health is about providing safe and healthy living conditions. It depends, among other things, on the buildings in which people live, the water they drink, the safe removal of waste and control of pests. Just as important will be the food they eat, their ability to clean themselves, their clothes and their homes.
Rates of diseases associated with poor environmental health
Hospital admissions data suggest that environmental-based diseases are much more common among Indigenous than non-Indigenous people. Improvements in sanitation, drinking water quality, food safety, disease control and housing conditions are major contributory factors to improving health and quality of life.
Research in Indigenous communities has found that infected secretions from eyes, nose, ears and coughs play a major role in transmitting infectious diseases — especially in overcrowded households. Inadequate waste disposal, leading to a pool of potentially infected material in the immediate living area, is also a major source of infectious disease.

Box 1.33	KEY MESSAGE	
Indigenous people had much higher hospital separation rates (admissions) for influenza and pneumonia in 2002-03 (121 per 10 000 people) than other people (32 per 10 000 people) (table 10.1.1).	
	
	Access to clean water and functional sewerage
Contaminated drinking water can be a source of sickness and disease. An adequate and reliable supply of water is necessary for personal hygiene as well as washing food, kitchen utensils and clothes. This is important in preventing infectious diseases and other illnesses. A functional sewerage system prevents contamination of drinking water and food.

Box 1.34	KEY MESSAGE	
In 2002, nearly all Indigenous households had access to a working toilet and facilities for washing people, clothes and bedding within their homes. However, no information was available on the quality or reliability of communal drinking water and sewerage services to which household taps, showers, sinks, baths and toilets were connected.	
	
	Overcrowding in housing
Overcrowding in housing can be a significant contributor to poor health, family violence and poor educational performance. The quality and condition of housing can also influence health outcomes.
The housing occupancy standard compares the number of bedrooms with the number of people in a dwelling, to determine overcrowding. However, particularly in larger households, the number of bathrooms and toilets, and the size of kitchens, bedrooms and other living spaces may be as important as the number of bedrooms.

Box 1.35	KEY MESSAGES
•	In 2002, 26 per cent of Indigenous people aged 15 years and over (72 600 people) lived in overcrowded housing (figure 10.3.1 and table 10A.3.3).
•	Overcrowding was most common in very remote areas (figures 10.3.3 and 10.3.4).	
	
	Economic participation and development 
The extent to which people participate in the economy is closely related to their living standards and broader wellbeing. It also influences how they interact at the family and community levels. 
This report examines economic development through employment opportunities, influence over land resources, and aspects of education and training that are relevant to the goals of good governance and the capacity to govern.
In addition, two case studies on governance arrangements are presented: the Thamarrurr Council in Wadeye, NT and the Koorie Heritage Trust in Victoria.
Employment by sector, industry and occupation
Having a job leads to improved incomes and standards of living for people and their families. This in turn has a positive influence on health and the education of children. It also enhances self-esteem and reduces social alienation. More broadly, where people are employed, benefits also flow on to the wider community.
The type of employment that people are engaged in may also have an impact on their social and economic wellbeing. 

Box 1.36	KEY MESSAGES
•	Between 1994 and 2002, Indigenous employment rates increased from 68 to 80 per cent of the labour force, with increases in all age groups (figure 11.1.4). This is attributable to increases in part time employment rather than full time employment (tables 11A.1.3 and 11A.1.4).
•	The full time employment rate in 2002 for Indigenous people was much lower than that for non-Indigenous people for both males and females. Nationally, the age standardised ratio of Indigenous to non-Indigenous full time employment was 0.7 (figure 11.1.1).
•	Indigenous employment had a significant part time component in 2002. Nationally, the age standardised ratio of Indigenous to non-Indigenous part time employment was 1.3 (figure 11.1.2).
•	CDEP participation contributes significantly to the number of Indigenous people who are recorded as employed, particularly in very remote areas.	
	
	Community Development Employment Projects (CDEP) participation
The CDEP scheme provides employment and training opportunities to over 36 000 participants. The scheme is designed to provide meaningful employment and training to Indigenous people in a range of activities that can benefit them and their communities.
The scheme can be a stepping stone for Indigenous people into mainstream employment. It can also overcome barriers for low and non-skilled people who would otherwise find it difficult to obtain employment.

Box 1.37	KEY MESSAGES	
•	There were over 36 000 CDEP participants at 30 June 2004. CDEP participation increased with geographic remoteness, ranging from 4 per cent of the Indigenous population in major cities to 45 per cent in very remote areas (figure 11.2.1). 
•	The CDEP scheme accounted for 8 per cent of Indigenous employment in major cities increasing to 74 per cent in very remote areas (table 11A.2.1).	
	
	Long term unemployment
People who have been unemployed for long periods generally experience greater financial hardship and lower levels of social attachment. They will also have greater difficulty in finding employment, because of loss of relevant skills, and employers’ perceptions about their ‘employability’.
Long term unemployed Indigenous people are also more likely to be arrested and to have chronic health problems. 

Box 1.38	KEY MESSAGE	
Nationally in 2002, around 8800 Indigenous people aged 18 to 64 years, or 28 per cent of unemployed Indigenous people, were unemployed long term (figure 11.3.2).	
	
	Self employment
Self employment is one way that Indigenous people can reduce dependence on government welfare and improve self reliance. It also enables them to participate in the economy and improve their economic wellbeing.
Governments have typically emphasised business opportunities at the Indigenous community level rather than for self employment. Projects such as the Indigenous Enterprise Partnerships provide assistance to Indigenous business and foster economic and social development.

Box 1.39	KEY MESSAGES	
•	There are no recent nationally comparable data that can be reported for the Indigenous self employment indicator other than the 2001 Census data that were published in the 2003 Report. 
•	These showed that nationally in 2001, Indigenous people were three times less likely than other people to be self employed, increasing to nine times less likely in very remote areas (SCRGSP 2003).	
	
	Indigenous owned or controlled land
Ownership and control of land can provide both economic and cultural benefits to Indigenous people. As well as yielding benefits in the form of customary activities (for example, fishing, hunting and gathering) and commercial activities (for example, mining royalties, tourism), Indigenous owned or controlled land can provide them with a place to live. This might be through either individual home ownership or community housing.

Box 1.40	KEY MESSAGES	
•	Indigenous people obtain a variety of economic, social and cultural benefits from land they own or control.
•	Between 2003 and 2004, the area of land where native title has been determined to exist increased by 2 per cent (6800 km2) (figure 11.5.2).
•	In this period, the number of Indigenous Land Use Agreements increased from 84 to 130 (figure 11.5.3).	
	
	Accredited training in leadership, finance or management
Capacity building for good governance can take many forms. This indicator provides information on Indigenous participation in those mainstream courses which are regarded as particularly useful in developing skills relevant to a capacity to govern. These comprise management and commerce, economics and business law. This is not to imply that students in other courses may not also be well equipped to provide leadership and contribute to good governance. 

Box 1.41	KEY MESSAGE	
In 2003, lower proportions of Indigenous than non-Indigenous university students (9 per cent and 24 per cent, respectively) and TAFE students (39 per cent and 45 per cent) were studying management, commerce, business law or economics (figures 11.6.1 and 11.6.3).	
	
	Case studies in governance arrangements
Governance has been closely linked with economic development and disadvantage, because it is a key determinant of the ability of Indigenous organisations and communities to make and implement decisions that achieve outcomes in a sustainable way.
Indicators of good governance are difficult to construct, but case studies can provide useful insights. In this year’s Report two case studies are presented. One is on the Thamarrurr Regional Council in Wadeye, NT. The second deals with the Koorie Heritage Trust in Victoria.

FUTURE DIRECTIONS IN DATA
Notwithstanding some improvements, data for Indigenous people remain deficient in a number of key areas. Some priorities for data development are listed below:

Indicator	Data priority	
Life expectancy and causes of death (various indicators)	•	Continue work on improving quality and availability of Indigenous data, including changes over time.	
Substantiated child protection notifications; children on care and protection orders	•	Develop data collections to better reflect the underlying extent of child protection issues that are not necessarily apparent from administrative data on substantiations, notifications and orders.	
Alcohol and tobacco consumption; drug and other substance use	•	Collect regular data comparing Indigenous and non-Indigenous consumption and more robust data by jurisdictional and geographic levels are required.	
Birthweight	•	Extend data collections to babies born to non‑Indigenous mothers who have Indigenous fathers.	
Hearing impediments	•	Collect data to enable the assessment of the true burden of hearing loss and the type and severity of ear infections in the Indigenous population.	
Years 3, 5 and 7 literacy and numeracy	•	Collect learning outcomes data to provide timely data by geographic regions.	
Preschool and school attendance	•	Collect uniform national data and ensure consistency and comparability of data across geographic regions.	
Primary school children with dental caries	•	Expand the availability of comparable data on children’s dental health.	
Juvenile diversions	•	Collect comparable national data	
Self employment	•	Collect regular data on Indigenous business and self-employment.	
Access to clean water and functional sewerage	•	Collect regular data allowing comparison between services in Indigenous communities and those delivered by major utilities.