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Indigenous health

Feb 21, 2011

The PM's report on Closing the Gap report has plenty of holes

As previously reported, the Prime Ministe


As previously reported, the Prime Minister recently released a report investigating what progress has been made in achieving targets for reducing the gap in Indigenous disadvantage around:

• life expectancy
• mortality rates for Indigenous children under five
• access to early childhood education for all Indigenous four year olds in remote communities
• reading, writing and numeracy achievement for Indigenous children
• Year 12 or equivalent attainment rates for Indigenous young people
• employment outcomes.

Health policy expert Dr Lesley Russell has been having a close look at the report and concludes, in her piece below, that it is “long on rhetoric and factoids but short on meaningful data, measurable progress and real transparency”.

Hopefully a COAG report that is due mid-year will provide a more forensic examination of progress to date.

Thanks to Australian Policy Online for allowing this cross-posting.

How does the PM’s report stack up?

Dr Lesley Russell writes:

Last year my colleague Sarah Wenham and I produced a report that looked at progress made towards meeting the Australian government’s commitment to closing the gap on Indigenous disadvantage. We found that there was a real paucity of quality data and consequently little ability to measure any progress against the targets that former Kevin Rudd enunciated in February 2008.

The release of Closing the Gap – Prime Minister’s Report 2011 marks the passage of three years since these promises were first made. Since then the government has committed $8.2 billion in Indigenous-specific National Partnership Agreements. But while the beautifully produced, glossy report is full of facts and numbers about how many services have been delivered and how many dollars have been spent, information on outcomes is in short supply.

Here is a succinct analysis of what the 2011 report says.

Target: Closing the gap on life expectancy within a generation

The data provided for life expectancy are from 2005–07 and are the same data as in the 2010 report. It is disturbing that quality data regarding this target is available only from Western Australia, South Australia and the Northern Territory.

In tackling this particular disparity, it is important that the focus is wider than life expectancy at birth. While deaths of non-Indigenous Australians are concentrated in the older age groups, this is not true for Indigenous Australians. In the two states and the territory for which data are available, deaths of both men and women in the 35–44 years age group were seven times higher for Indigenous people than for non-Indigenous people, and in the age group 45–54 years deaths were at least six times higher. These early deaths are due primarily to heart disease, liver disease, and diabetes, virtually all of which are preventable.

Target: Halving the gap in mortality for children under five with a decade

Data from New South Wales, Queensland, Western Australia, South Australia and the Northern Territory show that in 2008 for the mortality rate for Indigenous children aged 0–4 years was 221 per 100,000, compared to 100 per 100,000 for non-Indigenous children. Interestingly, the 2008 figure quoted in the Prime Minister’s 2010 closing the gap report was 205 per 100,000 for Indigenous children, so it seems that the Australian Bureau of Statistics has revised these figures.

In looking at deaths in this age group there are two broad issues to consider: the causes of infant mortality (0–1 years) and the causes of death in young children up to five years of age. Indigenous infant mortality rates vary considerably across Australia, ranging from 7.7 deaths per 1000 live births in New South Wales to 13.6 in the Northern Territory. The rate for non-Indigenous infants is around 4. The National Indigenous Health Equity Council estimated the national Indigenous infant mortality rate at 10 deaths per 1000 live births in 2006 and predicted that, at current rates of improvement, it would match non-Indigenous rates (at around 4) in 2018. But there has been no substantial decrease in low-birthweight babies born to Indigenous mothers in recent years, a factor in infant mortality that should be of considerable concern.

A Save the Children report released in October 2009 showed that Australia’s Indigenous children aged under five are dying at a rate comparable to some of the world’s poorest countries. They are three times more likely to die before their fifth birthday than non-Indigenous children, with accidents, poisonings, malnutrition and a lack of health care services primarily to blame.

Target: All four-year-olds in remote communities will have access to early childhood education within five years

There is some evidence of progress towards this goal, with 64 per cent of children enrolled in preschool in 2009. While this figure is considerably below target, it does represent real progress. The report states that more robust data will be collected in 2011 and made available in 2012.

Target: Halve the gap for children in reading, writing and numeracy within a decade

The report cites 2009 data and states that there are “some positive signs” and that further data will be available later in 2011. Curiously, the report chooses not to compare the 2009 data with the comparable 2008 data presented in the 2010 report – perhaps because the progress is rather mixed. Still, this is the transparent way to measure progress.

Target: Halve the gap for Indigenous students in Year 12 attainment (or equivalent) by 2020

The data presented for this target is the same 2006 data as in the 2010 report. There is some additional information provided to show that the retention rate for Indigenous students in year 7/8 to 12 has increased from 30.7 per cent in 1995 to 45.5 per cent in 2009. But this information does not fit well with the figures given for year 12 retention in 2006 of 47.4 per cent (considerably less than that for non-Indigenous students at 83.8 per cent) and suggests that Indigenous retention rates in the later years of schooling are in fact declining.

Target: Halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade

Again, the data presented for this target is the same 2008 data as in the 2010 report. At that time the Indigenous employment rate (53.8 per cent) lagged well behind the non-Indigenous rate (75 per cent). Given that the employment gap is a function of education levels, it will be important for current data limitations to be overcome so progress towards this target can be measured and reported.

Investing in data

This is now the third Prime Minister’s report on closing the gap, and regrettably the 2011 report has all the problems of the 2009 report – long on rhetoric and factoids but short on meaningful data, measurable progress and real transparency. The federal government has committed $4.9 million to improving Indigenous data collection. It is clearly time that an extra effort was invested in this important activity, and that the states and territories were recruited as active partners in this effort.

The Council of Australian Government’s Reform Council is due to provide an independent and comprehensive report each year on progress towards the closing the gap targets, and the first report is due for release in mid 2011, so perhaps this will contain more meaningful information. Otherwise we have no way to know whether the billions of dollars that have been committed to activities to close the gap are delivering value and whether the nation’s promise to our Indigenous people is being met.

• Lesley Russell is a Senior Fellow at the Center for American Progress in Washington DC. She is a research associate at both the Menzies Centre for Health Policy and the US Studies Centre at the University of Sydney.


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2 thoughts on “The PM’s report on Closing the Gap report has plenty of holes

  1. Tweets that mention The PM’s report on Closing the Gap report has plenty of holes – Croakey -- Topsy.com

    […] This post was mentioned on Twitter by Sunili and Ben Harris-Roxas, Melissa Sweet. Melissa Sweet said: The PM's recent Closing the Gap report is more gloss than substance. Thanks to Aust Policy Online for the cross-post: http://bit.ly/eKcZQx […]

  2. Murf

    There’s a problem obtaining data from indigenous people- they mostly don’t like research- they’re sick of it because it feels as though they have been giving and giving for more than 100 years but they perceive they are getting nothing of value back. Although professionals may be able to get people to return to a treatment centre several times to receive a series of vaccinations, they won’t return after 6 months to answer a few questions and have a blood sample taken- that’s research and they feel as though they are being exploited. Many non-indigenous Australians feel the same way but will return because they have grown up in a culture of co-operating with “the doctor”. So it is probably true that many services have been dispensed and dollars spent, but data gathering may have been difficult because its done in a “white way”. We need to find innovative ways of gathering useful data without seeming to exploit indigenous people. I know these days we aren’t all exploiting them, but they feel very much in the spotlight and they can see their neighbours are still ill and not living very long, so they probably see our data gathering as pointless. It’s not doing any good criticising the PM’s or anyone else’s report, imho. We have to find new ways of tracking progress or miraculously convince indigenous Australians to become perfect research subjects!

https://www.crikey.com.au/2011/02/21/the-pms-report-on-closing-the-gap-report-has-plenty-of-holes/ == https://www.crikey.com.au/free-trial/==https://www.crikey.com.au/subscribe/

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