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Close the Gap: social justice

Tom Calma
Med J Aust 2009; 190 (10): 526.
Published online: 18 May 2009

We need a stronger focus on the social determinants of health

Since 2006, Australia’s peak Indigenous and non-Indigenous health bodies, non-government organisations and human rights organisations have worked together on the Close the Gap campaign for Aboriginal and Torres Strait Islander health equality by 2030. The key elements of their approach are:

  • A comprehensive national plan of action that is properly resourced and that has the goal of closing the health and life expectancy gap between Indigenous and non-Indigenous Australians within a generation. This is vital to ensure that governments work towards Indigenous health equality in a coordinated fashion (including the many reform processes currently underway), and that none of the determinants of Indigenous health inequality are missed.

  • A partnership for Indigenous health equality between government and Indigenous peoples and their representatives.

  • Within the national plan, a targeted approach to achieving Indigenous health equality, focusing on a wide range of health conditions and health determinants. The campaign partners have developed a comprehensive set of Close the Gap National Indigenous Health Equality Targets (http://www.humanrights.gov.au/social_justice/health/targets) to guide this target-setting process. These were presented to the Australian Government in July 2008.

  • Support for Aboriginal community-controlled health services.

The good news is that Australian governments have already committed to this approach through:

  • Bipartisan support for the Close the Gap Statement of Intent, signed by the Prime Minister in March 2008 (see: http://humanrights.gov.au/social_justice/health/statement_intent.html) — this alone represents a historic turning point in the approach to Indigenous affairs in this country; and

  • Commitments by the Council of Australian Governments, where Australian governments have committed to closing the life expectancy gap within a generation, halving the mortality gap between Aboriginal and Torres Strait Islander and non-Indigenous children under 5 years of age, and the provision of record levels of new funding to support this.

However, despite substantial investments in Indigenous health as a result of the campaign, progress has been slow in turning the commitments around planning and partnership into action, and there needs to be a stronger focus on the social determinants of health rather than simply a health sector response. This remains the challenge of the campaign partners over 2009–2010.

  • Tom Calma

  • Australian Human Rights Commission, Sydney, NSW

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