Aboriginal and Torres Strait Islander health
The health of Australia's First Peoples, the causes of health inequity, and how doctors deliver culturally safe care.
High-yield points
Aboriginal and Torres Strait Islander people make up about 3.8% of the population (2021 Census).
There is a life expectancy gap of around 8-9 years compared with non-Indigenous Australians.
Ask every patient whether they identify as Aboriginal and/or Torres Strait Islander; you cannot tell by appearance.
The annual Aboriginal and Torres Strait Islander health assessment (Medicare item 715) covers all ages.
Higher burden of diabetes, CKD, cardiovascular disease, rheumatic heart disease, otitis media, trachoma and smoking-related disease.
Aboriginal Community Controlled Health Services (ACCHSs) and Aboriginal Health Workers and Practitioners are central to care.
Social determinants, racism and the intergenerational trauma of colonisation and the Stolen Generations drive health outcomes.
Cultural safety is defined by the patient's experience, not by the doctor's intentions.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Context | Tribal health has some parallels, but the history is different. | Colonisation, dispossession and the Stolen Generations drive today's health gaps. Closing the Gap sets national targets. |
| Asking identity | Not applicable. | Ask every patient if they identify as Aboriginal and/or Torres Strait Islander; don't assume from appearance. |
| Services | Not applicable. | Aboriginal Community Controlled Health Services; involve Aboriginal Health Workers or Practitioners; annual health check; PBS co-payment help. |
| Communication | Doctor-led, often directive. | Cultural safety is judged by the patient. Involve family, allow time, avoid jargon, respect Sorry Business and gender-specific business. |
Context
India (MBBS)
Tribal health has some parallels, but the history is different.
Australia (AMC): what the exam expects
Colonisation, dispossession and the Stolen Generations drive today's health gaps. Closing the Gap sets national targets.
Asking identity
India (MBBS)
Not applicable.
Australia (AMC): what the exam expects
Ask every patient if they identify as Aboriginal and/or Torres Strait Islander; don't assume from appearance.
Services
India (MBBS)
Not applicable.
Australia (AMC): what the exam expects
Aboriginal Community Controlled Health Services; involve Aboriginal Health Workers or Practitioners; annual health check; PBS co-payment help.
Communication
India (MBBS)
Doctor-led, often directive.
Australia (AMC): what the exam expects
Cultural safety is judged by the patient. Involve family, allow time, avoid jargon, respect Sorry Business and gender-specific business.
The Australian context
This area has no direct Indian equivalent and is heavily examined. Learn the history (colonisation, Stolen Generations), the Closing the Gap framework, and practical care: involve family and Aboriginal Health Workers, allow time, avoid jargon, and respect cultural business (e.g. Sorry Business, men's and women's business).