"My mob are dying." I'm an Aboriginal woman. Here's what I want you to know about our health.

Since the beginning of the COVID-19 pandemic in early 2020, people's health literacy has increased dramatically. 

I've worked in public health since 2009. Before the pandemic, most people had no idea that public health existed as a career! Now, most people understand epidemiology is not a skin condition. 

They also are more likely to understand a virus reproduction rate. And they can describe the primary differences between the Pfizer and AstraZeneca vaccinations. 

COVID-19 is complex, as is Aboriginal and Torres Strait Islander health, so what's the difference? 

The significant difference is that COVID has affected Australia and the world. Whereas the Aboriginal and Torres Strait Islander health disparity, on a day-to-day level, impacts just us.

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COVID seems to headline every news report on TV, make the newspaper's front page and is likely to be one of the most frequently searched terms online. 

However, unlike COVID-19, Aboriginal and Torres Strait Islander health disparity is poorly understood despite being an issue for not two years but 233 years; since 1788.

So, what should you know about Aboriginal and Torres Strait Islander health? 

Firstly, while you are looking away, either because it doesn't impact you, it's too hard, or you're too busy, my mob are dying. 

Aboriginal and Torres Strait Islander babies born today die younger. 

Girls will die seven years earlier and boys 8. 

Secondly, it's not just about dying younger; it's also about the quality of life. 

Chronic diseases like diabetes and mental health impact our quality of life. Yet treating or even trying to prevent a single disease is merely treating a symptom.  

We also know that Aboriginal and Torres Strait Islander people are three times less likely to own their homes. 

We are much less likely to have finished Year 12 and even less likely to have a tertiary education. And are also much more likely to be unemployed. 

Other than that, there are three things I want you to know about Aboriginal and Torres Strait Islander health.

1. Health isn’t just about health.

This is a big one. 

The reasons for poorer health outcomes are complex and include a range of historical, political and social factors. 

Issues impacting Aboriginal and Torres Strait Islander people's health include previous and ongoing elevated rates of child removals, cultural loss and disconnection, dispossession of land, historical wealth, and racism. 

These issues and more cause trauma, which also impacts our health.

History shapes the future. 

Socioeconomic (income, education and employment), behavioural (e.g. diet and exercise), and biomedical (e.g. blood pressure and cholesterol) risk factors drive and shape health outcomes. 

However, socioeconomic factors account for almost one-third of the gap in the burden of disease. And represent nearly three times the burden accounted for by behavioural and biomedical factors. 

The old chicken or egg analogy works best here. 

For example, our level of income dictates where we can live. And where we live dictates what opportunities might be available to our families and us. 

Do we live in a house with heating and cooling? In an area that has good schools? Is our home in an area with access to fresh and healthy food or surrounded by unhealthy foods? That's if food can be afforded. Is public transport available and accessible to increase our options?

So what does this mean for Aboriginal and Torres Strait Islander people? 

There are many reasons for these circumstances, mainly though the disadvantage is a legacy of past government policies driven by racism. 

My grandmother was born on Cummeragunja Mission on the NSW and Victorian border. 

Missions were controlled by the state/territory, including in NSW. This meant people couldn't own property on the Mission. 

Up until the 1950s Aboriginal children could be excluded from NSW schools. Then there were the policies in every state and territory that saw children removed from their families for no other reason than they were Aboriginal. 

This has become known as the Stolen Generation. 

These policies and the myriad of others were also explicitly developed for or excluded Aboriginal and Torres Strait Islander people. 

Creating circumstances that had real consequences for our health today. 

They have reduced the likelihood of our mob owning a house, getting a good education and caused incredible amounts of trauma, which on its own is hugely life-limiting. 

2. Aboriginal and Torres Strait Islander people need to drive their solutions.

So what needs to be done? Historically, policies and programs about us have been designed without our engagement. 

They have been created by people who haven't lived our lives. People who don't understand our cultures and have no concept of what we truly need. 

If we have been lucky, we may have been consulted, or at least some of us. 

On a macro-level, the solution is Aboriginal and Torres Strait Islander people being able to make decisions for ourselves as outlined in the Uluru Statement from the Heart. 

The Statement calls for three things, 

1. a constitutionally enshrined voice to government, 

2. a truth-telling process and 

3. a treaty. 

We know our truth: Australia has yet to reconcile its existence with our truth. This means that Aboriginal and Torres Strait Islander people know our communities best. 

Therefore, we need to be in the driver's seat. This can be achieved through the Voice to Parliament and treaty. 

It's worth noting that the Aboriginal and Torres Strait Islander peoples are one of the only Indigenous peoples in the Commonwealth without a treaty. 

3. We need your support to see fundamental changes

Health, including Aboriginal and Torres Strait Islander people’s health, is not just about individual choices and health issues. 

We have learned from COVID that health is not just a personal responsibility. 

It is a whole of the population and all of the government responsibility. That means Aboriginal, and Torres Strait Islander people's health is your responsibility too.

So what am I asking of you? 

I'm asking you to think. To read beyond this article. To empathise. To move beyond the simplistic to the complex. To expect more of yourselves, your families and friends. To seek more from your schools. Your health provider. Our politicians. To advocate for Aboriginal and Torres Strait Islander self-determination.

I ask you to be part of the solution which heralds a better future for Aboriginal and Torres Strait Islander people rather than part of the problem.

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