Concerns about inequalities in health care access, service provision and health outcomes for global Indigenous populations have prompted regulatory bodies and health services and professionals to examine how they can better meet the health care needs of Indigenous groups. There is ample evidence of inequalities in health status and health care between Aboriginal and Torres Strait Islander Australians (referred to as Indigenous Australians in this report) and non-Indigenous Australians. These inequalities are particularly apparent in chronic and communicable diseases, infant health, mental health, and life expectancy (AIHW 2013; AIHW 2015; ATSISJC 2005; SCRGSP 2013). Many factors contribute to these inequalities, with perhaps the largest contributors being those related to social factors that lie outside the health care system (Osborne et al. 2013). There is also evidence that inequitable access to quality healthcare based on ethnicity has contributed to health disparities (Betancourt et al. 2003; SCRGSP 2013).
Globally, researchers and others have long reported the negative impacts that ethnocentric health service provision has on the health status of Indigenous populations (Downing et al. 2011). The lack of Indigenous health workers in health service delivery systems leads to Indigenous people delaying going to services and contributes to the under-use of healthcare services (LaVeist et al. 2003). There is increasing evidence that health disparities between Indigenous Australians and non-Indigenous Australians are linked to accessibility. Accessibility is influenced by economic and geographic factors and a variety of sociocultural factors (Thomson 2005). It is therefore important to increase efforts to improve the ability of all systems, services and practitioners to work with the diversity of patients. In reporting on the state of the health of the world’s Indigenous peoples, Cunningham (2009) stated that: To improve the health situation of Indigenous peoples, there must thus be a fundamental shift in the concept of health so that it incorporates the cultures and world views of Indigenous peoples as central to the design and management of state health systems (Cunningham 2009:156).
