By Emma Carolan, CRA Justice Research Officer
An representation of the COVID-19 virus. IMAGE: Center for Disease Control and Prevention.
Globally, Indigenous Peoples are at a disproportionate risk when faced with a public health crisis, due to a high rate of socio-economic marginalisation. The COVID-19 Global Pandemic has been no exception, although according to the UN's Indigenous Peoples and Development Branch/Secretariat of the Permanent Forum on Indigenous Issues, exact rates of infection in Indigenous Peoples worldwide are either not yet available, or national infection statistics have not been recorded by ethnicity. This lack of effective monitoring and subsequent lack of early-warning systems compounds the risk to Indigenous Peoples. Anne Nuorgam, Chair of the United Nations Permanent Forum on Indigenous Issues declared in April, "We urge Member States and the international community to include the specific needs and priorities of indigenous peoples in addressing the global outbreak of COVID 19."
For Aboriginal and Torres Strait Islander Peoples, the COVID-19 pandemic has been a sharp reminder of the health inequities they face here in Australia, which have placed them at increased risk of severe health outcomes if the virus were to be contracted. Yet, remarkedly there have been no Aboriginal or Torres Strait Islander deaths to date, thanks to the extraordinary efforts of Aboriginal Community Controlled Health Organisations (ACCHOs) (hyperlink to page 2), who acted autonomously of the Australian government to protect their people. At the same time the pandemic has both exposed and further exacerbated other pre-existing social inequities.
According to the Department of Health’s Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19): Management and Operational Plan for Aboriginal and Torres Strait Islander Populations, Aboriginal and Torres Strait Islander Peoples are at higher risk of morbidity and mortality from, and a more rapid spread of, COVID-19. This is due to several health inequities, social determinants, and cultural practices that make them more vulnerable:
· Aboriginal and Torres Strait Islander Peoples experience a 2.3 times higher noncommunicable disease burden than the wider Australian population.
· Children may have reduced nutritional quality of diet.
· The spread of the virus could be facilitated by the shortages of housing and sound infrastructure, that lead to overcrowded living conditions.
· A 31% poverty rate can impinge on an ability to: adapt to rapidly changing emergencies; afford a loss of income resulting from a need to self-isolate; and prohibit the purchase of food, medicines and sanitation items.
· Lack of access to acute and primary health care and other health services due to remote location or limited transport options, and limited health care literacy, may prevent hospital or GP presentation for symptoms of COVID-19.
· Fears about racism, shame, removal of loved ones and mistrust of mainstream health services may further compound this vulnerability.
· Frequent and lengthy travel associated with family and cultural obligations, can increase contact with other communities, thereby increasing risk of infection transmission.
As Pat Turner, Chief Executive of the National Aboriginal Community Controlled Health Organisation warned in March this year, “I can’t be any blunter… if COVID-19 gets into our communities, we are gone.”
The new Closing the Gap agreement, announced in February 2020, has committed to tackling some of these inequities in its updated targets, including:
- Target all forms of mortality and the burden of disease from socio-economic factors to Close the Gap in life expectancy within a generation, by 2031 (target 1).
- By 2031, increase the proportion of Aboriginal and Torres Strait Islander children assessed as developmentally on track (target 5).
- By 2031, increase the proportion of Aboriginal and Torres Strait Islander people aged 25-64 who are employed to 62 per cent (target 8).
- By 2031, increase the proportion of Aboriginal and Torres Strait Islander people living in appropriately sized (not overcrowded) housing to 88 per cent (target 9).
The COVID-19 pandemic has been a stark reminder of just how imperative it is that these “gaps” are closed.