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Aboriginal and Torres Strait Islander peoples

Australian  Aboriginal and Torres Strait Islander peoples are the traditional owners of the land in Australia and hold a rich culture of traditional knowledge and beliefs that give insight into a history that stretches over 65,000 years. Aboriginal and Torres Strait Islander people is a broad term that encompasses over 250 different language groups that are spread across the land.  

As of 2016, Aboriginal and Torres Strait Islander peoples make up an estimated 3.9% of the total Western Australian population. Although only a small proportion of the population,  Aboriginal peoples made up 8.9% of hospitalisations due to injury between July 2006 and June 2015.1

To ensure that the rich historical knowledge and culture of Aboriginal and Torres Strait Islander peoples can continue, the health of the population should be fostered with a holistic approach to injury prevention and the incidence of injuries within this priority population need to be reduced.   

Impact of injury on Aboriginal and Torres Strait Islander peoples in Western Australia

Between 2014 and 2018, about 1 in 5 deaths among Aboriginal and Torres Strait Islander peoples in WA were caused by injuries, making it the second leading cause of death. 

Aboriginal and Torres Strait Islander people in WA experience an injury fatality rate higher than Aboriginal and Torres Strait Islander people residing in other States and Territories. In WA between the five year period 2011-12 to 2015-16, the age-standardised rate for all injury deaths in the Aboriginal and Torres Strait Islander population was 131 deaths per 100,000 population. In comparison to the Australian rate, this rate was 1.4 times higher than the national rate (95 injury deaths per 100,000 Aboriginal and Torres Strait Islander population).3 

In Western Australia between July 2016 and June 2017, Indigenous people were hospitalised due to injury at over two times the rate of non-Indigenous people (60.9 per 1,000 Indigenous people and 25.9 per 1,000 non-Indigenous people).2  

In Western Australia between July 2015 and June 2017, the leading causes of injury hospitalisations to Indigenous people were assault (28%, n=2,853), falls (17%, n=1,766) and mechanical forces (11%, n= 1,185).2 

Determinants of injury for Aboriginal and Torres Strait Islander peoples 

Low socioeconomic status 

Research indicates that low socio-economic status is associated with an increased risk of injury.4,5 In WA in 2016, the median weekly income for Aboriginal and Torres Strait Islander peoples aged 15 years and over was $398, compared to the WA State median of $724.6 A lower median weekly income can heighten Aboriginal and Torres Strait Islander people’s injury risk due to increased poverty-related stressors, poorer housing conditions, low health literacy, lower working conditions, and reduced access to medical care.4  

Racial discrimination 

Aboriginal and Torres Strait Islander peoples are inequitably affected by racism, which can influence injury risk through reduced access to healthcare, long-term psychological stress, prejudice, alcohol consumption and substance abuse.Results from the 2014-15 National Aboriginal and Torres Strait Islander Social Survey indicate that 37% of Western Australian Aboriginal and Torres Strait Islander peoples felt they had been unfairly treated at least once in the previous 12 months because they were Aboriginal and/or Torres Strait Islander.8 

Alcohol consumption 

A strong dose-response relationship exists between the amount of alcohol used and the likelihood of injury.9 Aboriginal and Torres Strait Islander people experience disproportionate harms from alcohol-related injuries.10 Harmful alcohol use among Aboriginal and Torres Strait Islander peoples and the resulting alcohol-related injuries have been attributed to cultural disconnection, trauma, social exclusion, community stressors and mental illness.11,12 

Effective Interventions 

Injury risk factors for Aboriginal and Torres Strait Islander peoples, including social isolation, a lack of culturally appropriate services and separation from culture, point to the urgent need to address the social and economic disadvantage to improve the social, emotional, cultural well-being and prevent injury to Aboriginal and Torres Strait Islander peoples. Interventions aiming to address injury prevention requires consultation, involvement and support from local Aboriginal and Torres Strait Islander communities throughout the development and implementation of strategies.13,14 This is to ensure culturally appropriate activities and the acknowledgement of persistent and underlying inequalities. 

Community campaigns 

When developing campaigns for Aboriginal and Torres Strait Islander peoples, it is essential to involve the local community in the planning, implementation and evaluation of the campaign.13 

Western Australian example: As part of the Road Safety Commission’s ‘Grow Up’ drink driving campaign, two Television Commercials were developed and rolled out in the northwest of WA to provide road safety messages in a culturally acceptable format to local Aboriginal people in the north-west of WA. 

Education programs 

Through education programs, at-risk individuals can increase their knowledge of the injury topic and public awareness of the injury area can also be raised. 

Western Australian example: Aiming to reduce the high suicide rate among Aboriginal and Torres Strait Islander youth in the Kimberley, the ALIVE and Kicking Goals projects peer education workshops, mentoring and one-on-one services are led by Aboriginal peoples. Results from the 12-month pilot indicate that through the Alive and Kicking Goals project peer educators learnt practical skills in suicide awareness and prevention.15 

Western Australian example: The Ironbark project  is an Aboriginal healthy ageing research project running in WA, NSW and SA for groups of Aboriginal men and women aged 45 years and older. The aim of the Ironbark project is to improve older Aboriginal people’s social and emotional wellbeing, strength, mobility and independence, and prevent falls. 

Cultural programs  

Due to the importance of acknowledging and understanding cultural history in re-establishing strong healthy communities, by focusing on cultural elements such as identity, and social and emotional wellbeing some programs have the potential to reduce the risk of injury to Aboriginal and Torres Strait Islander peoples.13 

Western Australian example: The Strong Spirit Strong Mind Metro Project aims to raise awareness of the harms associated with alcohol and other drug use among Aboriginal young people, families and communities and available support services in the Perth Metropolitan area. 

Organisations and programs in Western Australia

Click here to search for Aboriginal injury prevention activities in WA.

Injury Matters tailored Aboriginal and Torres Strait Islander peoples resources

Injuries to Aboriginal and Torres Strait Islander peoples Factsheet

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Injuries to Aboriginal and Torres Strait Islander peoples Resource Kit

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Move Improve Remove booklet for Aboriginal peoples

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Get Up Off The Floor – Using Arms or Knees (Illustrated)

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Shoe Safety Checklist

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Other resources

References 

  1. Data generated using HealthTracks Reporting, by the Epidemiology Branch, WA Department of Health in collaboration with the Cooperative Research Centre for Spatial Information (CRC-SI), April 2018. 
  2. Markus, M. L. Aboriginal and Torres Strait Islander Health Performance Framework 2020 key health indicators—Western Australia. 24 (2020). 
  3. Kreisfeld, R. & Harrison, J. Indigenous injury deaths: 2011–12 to 2015–16https://www.aihw.gov.au/getmedia/40b268d3-57d8-4eea-b02f-ec1406697c24/aihw-injcat-210.pdf.aspx?inline=truef (2020). 
  4. Kruithof, N., de Jongh, M. A. C., de Munter, L., Lansink, K. W. W. & Polinder, S. The effect of socio-economic status on non-fatal outcome after injury: A systematic review. Injury (2016) doi:10.1016/j.injury.2017.01.013
  5. AIHW: Henley, G. & Harrison, J. Injury mortality and socioeconomic influence in Australia 2015-16https://www.aihw.gov.au/getmedia/1e03d183-8b8f-4037-b4a4-e576bb22a9b0/aihw-injcat-208.pdf.aspx?inline=true (2019). 
  6. Australian Bureau of Statistics. Census Quickstats Western Australian, People: employment. http://www.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/5 (2016). 
  7. Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander Health Performance Framework 2020 summary reporthttps://www.indigenoushpf.gov.au/getattachment/65fbaaf3-100c-4df5-941c-a8455922693c/attachment.aspx (2020). 
  8. Australian Bureau of Statistics. 2014-15 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). (2017). 
  9. Taylor, B. et al. The more you drink, the harder you fall: A systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together. Drug and Alcohol Dependence 110, 108–116 (2010). 
  10. Gray, D. et al. Review of the harmful use of alcohol among Aboriginal and Torres Strait Islander people. (2018). 
  11. Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2019. (2020) doi:10.25816/E42P-A447
  12. Mental Health Commission. Western Australian Alcohol and Drug Interagency Strategy 2018-2022. (2018). 
  13. Dudgeon, P. et al. Solutions that work what the evidence and our people tell us: Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project report. (School of Indigenous Studies, University of Western Australia, 2016). 
  14. Closing the Gap Clearinghouse (Australia), Australian Institute of Health and Welfare, & Australian Institute of Family Studies. Family violence prevention programs in Indigenous communities. (Closing the Gap Clearinghouse, 2016). 
  15. Tighe, J. & McKay, K. Alive and Kicking Goals!: Preliminary findings from a Kimberley suicide prevention program. Advances in Mental Health; Maleny 10, 240–245 (2012).

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