Supporting Better Health Outcomes for First Nations Communities

The health of Aboriginal and Torres Strait Islander peoples is inseparable from their history, culture, connection to country, and the ongoing impacts of colonisation. Supporting better health outcomes for First Nations communities is not simply a matter of providing more services. It requires listening, learning, and fundamentally rethinking how health care is designed and delivered.

1. Understanding the Health Gap

The life expectancy gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians remains unacceptably wide — approximately eight years for males and seven years for females. Indigenous Australians experience higher rates of chronic disease, mental health challenges, cancer, diabetes, and respiratory illness. They are more likely to be hospitalised and less likely to receive timely, appropriate care.

These statistics are not inevitable. They are the measurable result of dispossession, poverty, racism, and the deliberate destruction of culture and community that began with colonisation and continues in various forms today.

1.1  The Social Determinants of Indigenous Health

Health is shaped by the conditions in which people are born, grow, live, work, and age. For many Aboriginal and Torres Strait Islander peoples, these conditions include overcrowded housing, food insecurity, limited access to clean water in remote communities, high rates of incarceration, inadequate educational opportunities, and persistent exposure to racism in everyday life including within health settings.

Addressing these social determinants is as important as providing clinical health services. Without tackling the root causes of poor health, even the best-designed health programs will have limited impact.

2. What Culturally Safe Healthcare Looks Like

Cultural safety goes beyond cultural awareness or sensitivity training. It means creating environments where Aboriginal and Torres Strait Islander people feel genuinely safe — emotionally, spiritually, culturally, and physically — to engage with health services without fear of discrimination or disrespect.

2.1  Community Control

Aboriginal community controlled health organisations (ACCHOs) are the gold standard for delivering health care to First Nations peoples. Governed and operated by Aboriginal communities, they provide comprehensive primary health care that is grounded in community needs, respectful of culture, and delivered by people who understand the communities they serve. There are over 140 ACCHOs across Australia, and they consistently achieve better health outcomes than mainstream services for Aboriginal patients.

2.2  Healing Country and Health

For many Aboriginal peoples, health is deeply connected to country — to the land, waterways, plants, animals, and spiritual places that are the foundation of cultural identity. Programs that incorporate connection to country, cultural practices, and traditional healing alongside biomedical care tend to be more effective and more widely embraced than purely clinical approaches.

2.3  Language and Communication

Australia is home to hundreds of Aboriginal and Torres Strait Islander languages. Providing health information and services in language — or at minimum, through interpreters who understand cultural context as well as words — is not optional. It is a fundamental requirement of culturally safe care.

3. Mental Health and Social and Emotional Wellbeing

The concept of social and emotional wellbeing (SEWB) is the Aboriginal and Torres Strait Islander framework for understanding mental health. It encompasses connections to body, mind and emotions, family and kinship, community, culture, country, and spirituality. It recognises that wellbeing cannot be separated from these interconnected domains.

Mainstream mental health services have often been poorly equipped to support Aboriginal people in a culturally safe way. Community-led initiatives, the 13YARN crisis line (13 92 76), and culturally grounded healing programs offer more appropriate pathways to support.

4. Digital Health and First Nations Communities

Digital health offers real opportunities to extend the reach of health services to remote and regional communities, provide information in language, and empower communities to take control of their own health journeys. However, digital solutions must be co-designed with communities to be effective.