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By Peter Carter, ISQua Board Member Thursday. Apr 18, 2019

Healthcare Disadvantage: Indigenous Minorities

Australia, the world's oldest continent is a product of the Dreamtime when the ancients known as the First Peoples travelled across the great southern land of Bandaiyan, creating and naming as they went. The Dreaming, as it is known, is the origin of spiritual values and reverence for country.    


The Health Board in New South Wales, Australia, of which I am a member, honours the traditional owners of the land on which it, and all its committees meet with the following opening remarks at each meeting:


We honour and pay our respects to the traditional owners of this land on which we meet and to the Elders past, present and future.


The respective relationships with the land of Indigenous and non-Indigenous Australians are epitomized in the following expressions: for non-Indigenous ‘this land is mine’ and for Indigenous this land is ‘this land is me’.


The complex and diverse Indigenous cultures of Australia are the oldest living cultural history in the world, going back at least 50,000 years, perhaps 65,000 years. At the time of first European contact, it is estimated that around 750,000 people lived in Australia.


You can imagine what the arrival of British colonists did to this ancient, rich, beautiful and fragile pattern!


This first settlement brought with it all manner of destruction for the Indigenous peoples not least of which was a wave of Old World epidemic disease; then followed the appropriation of native land and water resources.  The combination of disease, loss of land, social and cultural disruption and violence reduced the Aboriginal population in colonised areas by an estimated 90% within 12 years of white settlement.


This story is replicated elsewhere in the world.


Mythology told how the lands and lives of the Arctic Inuit were created and nurtured. The environment and animals of the Arctic and the adventures of the hunt created visions of spirits and fantastic creatures and the aurora borealis, or northern lights, might conjure images of family and friends visiting from the hereafter.  


European arrival in Inuit lands shattered this delicate system of beliefs so closely in tune with nature and caused widespread death through new diseases introduced by whalers and explorers, and enormous social disruptions.


European colonization of North America also had a devastating effect on the native populations through loss of land, disease, and enforced laws which violated their culture and through the introduction of guns, alcohol and horses. 


You can see the pattern here, and these are but a few examples of what has been repeated over thousands of years in many lands; colonists’ actions cause the emergence of minority groups who then become disadvantaged in numerous respects including in health. This disadvantage persists to this day.


As a group, Indigenous Australians have one of the lowest life expectancy rates in the nation. Today that life expectancy is on average 10 years less than for non-Indigenous Australians. A large part of this is due to chronic diseases such as cardiovascular disease, diabetes, cancer, chronic respiratory disease and chronic kidney disease.


Life expectancy figures for the Inuit population are complicated by the spread of Inuit peoples across a number of Arctic countries. However studies of life expectancy of Canadian Inuit peoples suggest it is 10 to 15 years less than for non-Inuit Canadians.


In the USA, the Agency for Healthcare Research and Quality reports that non-white Americans receive significantly worse care than white Americans.


That minority groups are with us and always will be is inescapable; but that the quality of the healthcare that many of these groups receive is poorer than the rest of the population should not be an inevitability.


The NSW Health District Board on which I serve encompasses the traditional lands of the Bundjalung, Yaegl, Gumbaynggirr and Githabul Nations. We are taking measures across this landscape to attempt to address disadvantage. Such measures include:


  • Promoting cultural awareness and respect, including in approaches to healthcare;
  • Establishing Indigenous run health services;
  • Increasing the Indigenous healthcare workforce;
  • Introducing Indigenous specific services (including for health rebate purposes);
  • Improving access to health services for Indigenous communities; and
  • Improving living conditions in Indigenous communities.

Much remains to be done.



The following sources were used in compiling this Blog:

Northern NSW Integrated Aboriginal Health and Well Being Plan 2015 – 2020.

Australian Museum Online:

Australian Government Culture and Recreation Portal:

Webster Online:

National Museum of Australia:

Publication No. AHRQ 11-0005-3-EF April 2011


Statistics Canada Health Reports


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