This report provides the latest information on how Aboriginal and Torres Strait Islander people in Western Australia are faring according to a range of indicators on health status, determinants of health and health system performance.

Indicators are based on the Aboriginal and Torres Strait Islander Health Performance Framework.

The report highlights the main areas of improvement and continuing concern. For example, while death rates for avoidable causes and circulatory diseases have declined since 1997, about half of Aboriginal and Torres Strait Islander mothers smoke during pregnancy and there has been no improvement in incidence rates of treated end-stage renal disease in recent years. The report finds areas of improvement in the health of Aboriginal and Torres Strait Islander people living in Western Australia, including: -a 35% decline in overall mortality from 1991 to 2010 and a 17% decline in avoidable mortality from 1997 to 2010 -a 27% decline in deaths due to circulatory disease, the leading cause of death for Indigenous Australians from 1997-2010 -a 62% decline in infant mortality rates from 1991-2010, and a significant narrowing of the gap between Indigenous and non-Indigenous Australians -a significant increase in health assessments recorded through Medicare since the introduction of the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes in July 2009 -corresponding increases in allied health care services claimed by Indigenous Australians through Medicare since 1 July 2009.

Indigenous Australians have higher rates of general practitioner management plans and team care arrangements than non-Indigenous Australians -immunisation coverage rates for Indigenous children are close to those for non- Indigenous children by age 2 -an increase in episodes of care provided by Indigenous primary health care services between 2008-09 and 2010-11 (from 305,712 to 473,132) -some improvements in literacy for Indigenous students in Year 3 and 7 between 2008 and 2011. Areas of concern include: -high rates of smoking during pregnancy (51%) -half of those aged 18 and over in non-remote areas have a disability or long-term health condition -mortality rates for chronic diseases are much higher for Indigenous Australians (9 times the rate of non-Indigenous Australians for diabetes and twice the rate for circulatory diseases) -no improvement in incidence rates of treated end-stage renal disease in recent years (currently 12 times the rate for non-Indigenous Australians) -high rates of hospitalisations and deaths due to injury (particularly assault, suicide and transport accidents) -over one-quarter (29%) of Indigenous Australians aged 15 and over in Western Australia live in overcrowded housing -barriers to accessing appropriate health care, such as cultural competency, continue to remain a problem -lower access to procedures in hospitals -unemployment rates continue to remain higher for Indigenous persons than non- Indigenous Australians (17% compared with 3% in 2008).