Sunday, November 1, 2015

Indigenous Australians: the brutal cycle of subpar education, healthcare, and poverty for a rural population


In many respects the story of Indigenous Australians and Torres Strait Islanders (hereinafter referred to as Indigenous Australians or people for readability) mirrors that of other native peoples.  As the European population spread over the continent, Indigenous peoples were marginalized, assimilated, or killed.  In Australia, from the 1870s to the 1970s (officially, 1969, but the practice continued in some locations for some time), indigenous children were forcibly removed from their communities.

The tragedy of the indigenous experience is one that is incredibly rich and complex, and I do not seek to do it justice in a single post.  However, the parallels of that experience to that of Native Americans is worth noting: many Indigenous Australians live in rural or remote areas, and experience the same issues as other remote populations: poverty, lack of access to education, healthcare, and social services, increased instances of substance abuse and domestic violence.  In Australia, the Indigenous population experiences rural issues at a higher rate than the white populations.  This post will focus on indigenous poverty, education, and healthcare; and the policies the Australian federal government may change under the leadership of Malcolm Turnbull.

For posts on the interplay between education and health in rural California, read this.  For a more comprehensive understanding of rural poverty and education in the US, read this.  For a post on rural health in the United States, read this

Indigenous Poverty 

Across Australia,  rural and remote poverty is slightly worse than it is in the "capital cities," 13.1% in rural areas vs. 12.6% in the cities.  For a more detailed breakdown of Australian demographics, see this. Poverty in the greater, rural Australian contexts several characteristics: 
  • lower income
  • declining employment opportunities
  • distance and isolation
  • reduced access to healthcare, education, and other social services.
Throughout most of Australia, the poverty rate is generally higher in rural areas, except in New South Wales and Western Australia (where the cost of housing in the capital cities; Sydney and Perth, is very high). 

Specific to Indigenous Australians, the average disposable income of an indigenous person is about 70% of that of a white Australian. The discrepancy between Indigenous and white Australians is exacerbated in rural Australia.  For example, in Cape York (the remote, northern peninsula in Queensland), the average Indigenous weekly income is $394, 45% of the white average income of $869.  In no region of Australia--remote, rural, or urbanized--do Indigenous Australians have a higher disposable income than white Australians. Furthermore, Indigenous Australians are 2.5% of the overall population, but accounted for nearly 25% of homeless people in the 2011 census. 

As of the 2011 census, the Indigenous unemployment rate was 17.1%.  Of the Indigenous Australians aged between 15 and 64, only 46.5% were employed, compared to 70.6% of white Australians.  
Clearly, despite the relatively small proportion of the Australian population that is Indigenous, this population is disproportionately poor, under-served, and resident in rural and remote areas.  In fact, only 1/3 of Indigenous Australians live in major cities.  The remaining 2/3 of the Indigenous populations live in inner regional (22%), outer regional (22%), remote (8%), and very remote (14%) areas.  For definitions of these terms, see my previous post and this map. This population distribution is very different from the non-Indigenous, urban centric population.  What causes this population and poverty discrepancy, and more importantly, how are the Australian state and federal governments addressing the problem? 

Indigenous Education

As of the 2011 census, Indigenous children comprised approximately 4.8 % of students, compared to Indigenous Australians comprising only 2.5% of the population.  This disparity is partly caused by higher fertility rates, but also because nearly all children of intermarriage are identified as Indigenous. Despite the higher proportion of Indigenous children, approximately 20% of Indigenous children failed basic literacy and numeracy tests. 

The failure of this 20% must be understood in light of diminishing goals under the Coalition of Australian Governments (COAG) (In 2008, the COAG changed the education goals from seeking to eliminate the gap between Indigenous and white Australians in 4 years to halving the gap between Indigenous and white Australians in 10 years--a pretty drastic change in goals).  See this for the full 2012 education report. 

A significant reason this policy shift has failed to reduce education gaps is that COAG identifies "Indignity" itself as the obstacle. In 2011, approximately $360 million was spent on "culturally appropriate" programs.  These programs basically take resources away from classroom instruction and divert it towards theatre specialists, puppeteers, and visual artists.  This money was essentially wasted. The states that spent the least on these programs were most successful in reducing the education gap.  Queensland spent $850 per student on these cultural programs and reduced the gap; whereas South Australia spent nearly $6000 per student on the cultural program and saw no change. 

The state of education is even worse in Indigenous schools--schools that enroll 75% or more Indigenous students. These schools enroll approximately 20,000 students, mainly in rural or remote areas without private sector employment and remain welfare dependent. Forty schools in the Northern Territory do not have a full time teacher every day of the week.  Across the board, these schools have a failure rate of 90%.  

Another 40,000 Indigenous students are enrolled "mainstream" schools with students from low socio-economic backgrounds, with high staff turnover and disciplinary problems.  
From 2011 to 2013, graduation rates and several other metrics improved slightly. However, in mid-level progress, there were significant gaps between Indigenous students and non-Indigenous students--nearly 61.6% literacy gap at schools in the Northern Territories. However, there was an improvement of 6.5% of Indigenous children attending the last year of schooling. 

In light of these slight improvements, the Australian government lowered the targets, to allow for 90% school attendance, and access to preschool for 95% of rural Indigenous populations under the age of 4.  Currently, 91% of these children have access to preschool.
In the 2015 COAG report, these education numbers remained disturbingly stagnant. For the full report, read this.  For the highlights, read on.  

Only two of the government's targets were met: halving the mortality rate for Indigenous children under 5 and halving the gap between Indigenous and non-Indigenous children finishing school.  In effect, since 2008, there has been no progress in improving literacy or numeracy among Indigenous children.  The COAG report, in making recommendations to the federal government, suggested making preventative health, and access to healthcare overall, a priority in reducing the education gap between Indigenous and white Australians.

Indigenous Healthcare 

Indigenous Australians have a life expectancy approximately 10 years shorter than non-Indigenous Australians.  Indigenous people also have high levels of preventable, treatable, and chronic medical conditions in higher percentages than the non-Indigenous population, including:
  • 3x the instances of diabetes
  • 2x the instances of chronic kidney disease
  • 4x the instances of advanced chronic kidney disease
  • 3x (and rising) the instances of Hepatitis C
The prevalence of poorer health clearly track with increased poverty, increased homelessness, decreased education, and the remoteness of major Indigenous population centers. For a comprehensive overview of Indigenous Australian health, read this.  

Like the causes and irritating factors of poverty, the Indigenous health gap is caused by a variety of factors, including: insufficient housing, insufficient education, and insufficient access to health services.  Generally speaking, Indigenous Australians should access healthcare much more often than non-Indigenous Australians; but the reality only suggest a marginal increase in access.  The discrepancy in this access can be attributed to the remote nature--and understaffed and underfunded.  In fact, 26% of Indigenous Australians seeking access to health services reported barriers.  The barriers to access were underfunding (and consequently higher costs to patients) and understaffing (causing longer wait times). 

Access to general practitioners (GPs, or your standard physician who performs physicals and treats general ailments) and preventative medicine is perhaps the single greatest challenge--and opportunity--for Indigenous Australian health.  In the rural and remote areas, access to GPs decreases significantly the further one moves away from cities.  In addition, preventable hospitalizations in these regions remain stable across non-Indigenous populations, but skyrockets for Indigenous Australians (in remote areas, nearly 300/1000 Indigenous people. were hospitalized for preventable ailments, compared to 50/1000 non-Indigenous people). 

Improving the Quality of Life for Indigenous Australians

Indigenous Australians face significant challenges in both urban and rural environments, but a significant portion of Indigenous Australians live in rural areas.  Therefore, the challenges they face--access to education and healthcare, as well as increased instances of domestic violence (discussed in my last post)--are exacerbated by lack of well-funded services and the remote nature of the communities.  Access to education and healthcare must increase if there is to be a significant change in poverty statistics.  So what can the Australian government do?

Under the Abbott government, the federal government changed the way it funds Indigenous programs, from nearly 150 individual programs to 5-broader strategies.  This changed reduced the amount of red tape and the number of bureaucrats in Indigenous communities.  However, Indigenous leaders feel that the change is only half complete.  The leaders will soon meet with PM Turnbull to discuss further changes, but no firm date has been set.  In the meantime, Turnbull will continue with an Indigenous Affairs Council.  But it remains to be seen how the new government will tackle years of stagnant educational change.  And one thing remains abundantly clear, the Indigenous population faces significant challenges, compounded by the exceedingly rural nature of Rural communities. 

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