Socio-economic outcome area 14

Aboriginal and Torres Strait Islander people enjoy high levels of social and emotional wellbeing

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Target 14

Significant and sustained reduction in suicide of Aboriginal and Torres Strait Islander people towards zero.

In 2022, the suicide age-standardised rate for Aboriginal and Torres Strait Islander people was 29.9 per 100,000 people (for New South Wales, Queensland, Western Australia, South Australia and the Northern Territory combined) (figure CtG14.1).

This is above the rate in the previous two years and also above the baseline in 2018 (25.1 per 100,000 people).

There is no specified trajectory or expected timeline for achieving zero suicide. This is because there is no acceptable rate of suicide – today or at any other time. A trajectory of a 75% reduction in the suicide rate is presented here. This trajectory was one of four (20%, 25%, 50% and 75%) developed through National Agreement processes and is presented here as it the most ambitious of the target trajectories.

Nationally, based on progress from the baseline, the target is worsening. This assessment is provided with a high level of confidence. Please refer to the How to interpret the data page for more information.

The state and territory assessments below reflect progress from the baseline (improvement, worsening or no change). There are no state and territory targets. The Australia assessment reflects progress from the baseline towards the national target.

NSWQldWASANTTotal
Assessment of progress 2018 to 2022Not applicable as required data not availableNot applicable as required data not availableNot applicable as required data not availableNot applicable as required data not availableNot applicable as required data not availableWorsening
Confidence level ..........High

right arrow improvement rectangle no change left arrow worsening not applicable as required data not available. tick good improvement and target on track to be met (Aust only). circle improvement but target not on track to be met (Aust only).

Note: These assessments of progress are provided with a 'High' or 'Low' level of confidence. An assessment reported with a High level of confidence is considered to be more reliable than one reported with a Low level of confidence. Please see the 'How to interpret the data' page for more information. Data for state and territory assessments that is consistent with the target specifications is not available. See disaggregations for state and territory five-year aggregate data.

Historical and ongoing target context

Social and emotional wellbeing (SEWB) is foundational for Aboriginal and Torres Strait Islander people’s physical and mental health (Dudgeon et al. 2014). Social and emotional wellbeing can be conceptualised as encompassing a broad range of interconnected dimensions which may include: autonomy, empowerment and recognition; family and community; culture, spirituality and identity; Country; basic needs; work, roles and responsibilities; education; physical health; and mental health (Butler et al. 2019). It should also be acknowledged that Aboriginal and Torres Strait Islander people exist in many diverse nations, cultures and language groups, with many perspectives – meaning that not all families and communities will share the exact same concepts of wellbeing. While social and emotional wellbeing (SEWB) and mental health are distinct, a decline in SEWB is associated with an increased risk of self-harm and suicide for Aboriginal and Torres Strait Islander people (Dudgeon et al. 2014).

Colonisation has had a concurrent and cumulative impact on Aboriginal and Torres Strait Islander social and emotional wellbeing (Dudgeon et al. 2014). Government policies such as dispossession of traditional land, the forcible removal of children from their families, disruption to culture and identity and the oppression of Aboriginal and Torres Strait Islander people has resulted in complex experiences of trauma and loss.

The transmission of intergenerational trauma and the continuing exposure to stressors compound to increase the susceptibility of Aboriginal and Torres Strait Islander people to poor SEWB (Darwin et al. 2023). Discrimination is a common experience for Aboriginal and Torres Strait Islander people and is a source of psychological distress (Priest et al. 2011; Thurber et al. 2021). This interpersonal discrimination is a health risk factor to be considered within the broader context of systemic and structural racism (Thurber et al. 2021).

Protective factors that can improve SEWB for Aboriginal and Torres Strait Islander people include:

  • Strengthening and restoring connection to culture, land, language and kinship (Bourke et al. 2018; Burgess et al. 2009; Colquhoun and Dockery 2012; Dudgeon et al. 2014; Kelly 2009).
  • Eliminating systemic and structural racism (Paradies et al. 2015; Thurber et al. 2021). For example, by transforming government institutions, agencies and practices.
  • Trauma-informed and ‘healing aware’, holistic models of care (Darwin et al. 2023).
  • Taking a strengths-based approach, for example,focusing on what Aboriginal and Torres Strait Islander communities have achieved through empowerment, wellness and wellbeing, positive psychology and decolonisation methodologies (Fogarty et al. 2018).
  • Self-determination, through Aboriginal community-controlled governance and structures that are consistent with traditional cultural practices (Dudgeon et al. 2014; Rigney et al. 2022).

References

Bourke, S, Wright, A, Guthrie, J, Russell, L, Dunbar, T and Lovett, R 2018, ‘Evidence Review of Indigenous Culture for Health and Wellbeing’, The International Journal of Health, Wellness, and Society , vol. 8, no. 4, pp. 11–27.

Burgess, CP, Johnston, FH, Berry, HL, McDonnell, J, Yibarbuk, D, Gunabarra, C, Mileran, A and Bailie, RS 2009, ‘Healthy country, healthy people: the relationship between Indigenous health status and “caring for country”’, Medical Journal of Australia , vol. 190, no. 10, pp. 567–572.

Butler, TL, Anderson, K, Garvey, G, Cunningham, J, Ratcliffe, J, Tong, A, Whop, LJ, Cass, A, Dickson, M and Howard, K 2019, ‘Aboriginal and Torres Strait Islander people’s domains of wellbeing: A comprehensive literature review’, Social Science & Medicine , vol. 233, pp. 138–157.

Colquhoun, S and Dockery, AM 2012, ‘The link between Indigenous culture and wellbeing: Qualitative evidence for Australian Aboriginal peoples’.

Darwin, L, Vervoort, S, Vollert, E and Blustein, S 2023, Intergenerational Trauma and Mental Health , Australian Institute of Health and Welfare.

Dudgeon, P, Hart, A and Kelly, K (eds) 2014, Aboriginal and Torres Strait Islander social and emotional wellbeing , 2nd edn, Department of the Prime Minister and Cabinet.

Fogarty, W, Lovell, M, Langberg, J and Heron, M-J 2018, Deficit Discourse and Strengths-based Approaches: Changing the Narrative of Aboriginal and Torres Strait Islander Health and Wellbeing , Lowitja Institute, https://www.lowitja.org.au/resource/deficit-discourse-strengths-based (accessed 27 February 2024).

Kelly, K 2009, Living on the edge: social and emotional wellbeing and risk and protective factors for serious psychological distress among Aboriginal and Torres Strait Islander people , Cooperative Research Centre for Aboriginal Health, Casuarina, N.T.

Paradies, Y, Ben, J, Denson, N, Elias, A, Priest, N, Pieterse, A, Gupta, A, Kelaher, M and Gee, G 2015, ‘Racism as a Determinant of Health: A Systematic Review and Meta-Analysis’, Public Library of Science, PLOS ONE , vol. 10, no. 9, p. e0138511.

Priest, N, Paradies, Y, Stewart, P and Luke, J 2011, ‘Racism and health among urban Aboriginal young people’, BMC Public Health , vol. 11, no. 1, p. 568.

Rigney, D, Bignall, S, Vivian, A and Hemming, S 2022, Indigenous Nation Building and the Political Determinants of Health and Wellbeing: Discussion Paper , Lowitja Institute, PDF, https://www.lowitja.org.au/publications (accessed 27 May 2024).

Sutherland, S and Adams, M 2019, ‘Building on the Definition of Social and Emotional Wellbeing: An Indigenous (Australian, Canadian, and New Zealand) Viewpoint’, ab-Original , vol. 3, no. 1, pp. 48–72.

Thurber, K, Colonna, E, Jones, R, Gee, G, Priest, N, Cohen, R, Williams, D, Thandrayen, J, Tom, C and Lovett, R 2021, ‘Prevalence of Everyday Discrimination and Relation with Wellbeing among Aboriginal and Torres Strait Islander Adults in Australia’, International Journal of Environmental Research and Public Health , vol. 18, p. 6577.

Williams, DR, Lawrence, JA, Davis, BA and Vu, C 2019, ‘Understanding how discrimination can affect health’, Health Services Research , vol. 54, no. S2, pp. 1374–1388.

Disaggregations

Data tables appear under figures

By state and territory

For the five years 2018–2022, after adjusting for differences in population age structures, the suicide rate for Aboriginal and Torres Strait Islander people was between 22.8 per 100,000 (New South Wales) and 38.1 per 100,000 population (Western Australia) across the five jurisdictions for which data was available (figure CtG14.2).

By sex

In 2022, after adjusting for differences in population age structures, the suicide rate for Aboriginal and Torres Strait Islander males for New South Wales, Queensland, Western Australia, South Australia and the Northern Territory combined was 3.3 times the rate for females (figure CtG14.3).

By age group

For the period 2018–2022, for New South Wales, Queensland, Western Australia, South Australia and the Northern Territory combined, the suicide rates for Aboriginal and Torres Strait Islander people aged 18–24 years, 25–34 years and 35–44 years (48.1, 48.4 and 52.3 per 100,000 population respectively) were more than twice the rates for Aboriginal and Torres Strait Islander people aged 45 years or over and 5–17 years (20.3 and 7.3 per 100,000 population respectively) (figure CtG14.4).

By sex, by age group

The data on suicide death rates, by Indigenous status, by sex, by age group is available in table CtG14A.6.

By remoteness area

For the period 2018–2022, the Australian suicide rate for Aboriginal and Torres Strait Islander people was higher in remote and very remote areas (30.8 per 100,000 population) compared to regional areas and major cities (26.5 and 25.5 per 100,000 population respectively) (figure CtG14.5).

(Suicide rates are available for national remoteness areas only. The data on the number of suicides (five-year aggregates), by state and territory, by remoteness area is available in table CtG14A.8.)

By sex, by remoteness area

The data on suicide death rates, by Indigenous status, by sex, by remoteness area is available in table CtG14A.9.

Target data specifications

Target 14: Significant and sustained reduction in suicide

Outcome:

Aboriginal and Torres Strait Islander people enjoy high levels of social and emotional wellbeing.

Target:

A significant and sustained reduction in suicide of Aboriginal and Torres Strait Islander people towards zero.

There is no specified trajectory or expected timeline for achieving zero suicide. A trajectory of a 75% reduction in the suicide rate is presented here as it is the most ambitious of the four target trajectories (20%, 25%, 50% and 75%) developed through National Agreement processes.

Indicator:

Suicide death rate of Aboriginal and Torres Strait Islander people.

Measure:

The measure is defined as:

Numerator – number of Aboriginal and Torres Strait Islander suicide deaths

Denominator – number of Aboriginal and Torres Strait Islander people in the population

and is presented as an age‑standardised rate per 100,000 people.

Target established:

National Agreement on Closing the Gap July 2020

Latest dashboard update:

6 March 2024

Indicator type:

Target

Interpretation of change:

A low or decreasing rate is desirable.

Data source(s):

Name (numerator): Causes of Death, Australia

Frequency: Annual (revised data for 2019 and 2020 included in the March 2024 Dashboard update – see Data quality considerations for further information)

Name (denominator): Estimates and Projections for Aboriginal and Torres Strait Islander population

Frequency: Annual (revised data for 2017, 2018, 2019, 2020, 2021 and 2022 included in the March 2024 Dashboard update)

Documentation (links): https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/

https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/estimates-and-projections-aboriginal-and-torres-strait-islander-australians

Data provider:

Provider name: Australian Bureau of Statistics (ABS)

Provider area: Causes of Death

Baseline year:

2018

Latest reporting period

2022

Target year:

2031

Disaggregations:

Total (includes New South Wales, Queensland, Western Australia, South Australia and the Northern Territory), Aboriginal and Torres Strait Islander people, single years

State and territory (New South Wales, Queensland, Western Australia, South Australia and the Northern Territory only) and total (five jurisdictions combined), by Indigenous status, five‑year aggregates

Total (includes New South Wales, Queensland, Western Australia, South Australia and the Northern Territory), by Indigenous status, single years

State and territory (New South Wales, Queensland, Western Australia, South Australia and the Northern Territory) and total (includes New South Wales, Queensland, Western Australia, South Australia and the Northern Territory), by Indigenous status by sex, five‑year aggregates

State and territory (New South Wales, Queensland, Western Australia, South Australia and the Northern Territory) and total (includes New South Wales, Queensland, Western Australia, South Australia and the Northern Territory), by Indigenous status, by age group, five‑year aggregates

Suicide death rate, total (includes New South Wales, Queensland, Western Australia, South Australia and the Northern Territory), by age group, by Indigenous status, by sex, five‑year aggregates

Suicide death rate, Australia, by remoteness area, by Indigenous status, five‑year aggregates

Suicide deaths, state and territory, by remoteness area, five‑year aggregates

Suicide death rate, Australia, by remoteness area, by Indigenous status, by sex, five‑year aggregates

Suicide deaths, Australia, by remoteness area, by Indigenous status, by sex, five‑year aggregates.

Computation:

Numerator divided by Denominator multiplied by 100,000.

Counting rules

Numerator:

  • Deaths from intentional self‑harm: includes ICD–10 codes X60–X84 and Y87.0.
  • Deaths are based on date of registration (not date of occurrence).
  • Deaths where the Indigenous status of the person is unknown or not stated are not included.
  • Rates for single year use single year deaths data. Rates for five years combined use the average of five years of deaths data.

Denominator:

Estimated population as at 30 June:

  • The Aboriginal and Torres Strait Islander population is calculated from Aboriginal and Torres Strait Islander population estimates and projections (series B).
  • The non‑Indigenous population is calculated by subtracting the Aboriginal and Torres Strait Islander population from the total population.
  • Rates for single year use single year population data. Rates for five years combined use the mid‑point of five years of population data.

Age-standardised rate:

Age‑standardised rates are calculated using the direct method using five‑year age groups from 0–4 to 75 years and over, with the Australian standard population as at 30 June 2001. For estimates by remoteness area, rates are calculated using five‑year age groups from 0–4 to 65 years and over. See the How to interpret data page for further information.

Disaggregations:

Causes of death statistics by jurisdiction and remoteness are based on usual residence of the deceased. Deaths of persons usually resident overseas which occur in Australia are included in the state/territory in which their death was registered.

Sex relates to biological sexual characteristics. Where the sex of the deceased has not been specified as male or female the death is excluded from the analysis by sex.

Remoteness area is classified according to the ABS 2016 Australian Statistical Geography Standard (ASGS) using SA1 as the building block. Data exclude deaths where residence was categorised as ‘migratory’, ‘no known usual residence’, ‘overseas’, or it was not sufficient to identify the geographic area and assign remoteness area.

Supporting calculations

Suicide death numbers.

Data quality considerations:

Reporting of rates is only for those jurisdictions which have adequate levels of Indigenous identification (New South Wales, Queensland, Western Australia, South Australia and the Northen Territory in line with national reporting guidelines), including the disaggregations. The exception is the data by remoteness which includes all jurisdictions (rather than the five jurisdictions in the target indicator) as data on the Estimated Resident Population (ERP) by remoteness are not available by jurisdiction.

For most jurisdictions the ABS Deaths and Causes of Death reports identify a death as being of an Aboriginal and Torres Strait Islander person where the deceased is recorded as Aboriginal, Torres Strait Islander, or both on the Death Registration Form (DRF) or the Medical Certificate of Cause of Death (MCCD). The use of this information from the MCCD has been introduced at different times across jurisdictions depending on when systems and processes have allowed for the ABS to use as follows:

  • From 2007 for South Australia, Western Australia, Tasmania, the Northern Territory and the Australian Capital Territory.
  • From 2015 for Queensland, which resulted in a noticeable decrease in the number of deaths for which the Indigenous status was ‘not stated’ and an increase in the number of deaths identified as Aboriginal and Torres Strait Islander. This impact is discussed in Life Tables for Aboriginal and Torres Strait Islander Australians, 2015-2017.
  • From 2022 for New South Wales, information from the MCCD has been used for the first time, which resulted in an increase in the number of deaths identified as Aboriginal and Torres Strait Islander. For more information on this change and the impacts refer to Technical Note: The impact of using two sources for deriving the Indigenous status of deaths in NSW in 2022.
  • For Victoria, the Aboriginal and Torres Strait Islander origin of the deceased continues to be derived from the DRF only.

For disaggregated data, single‑year estimates are subject to volatility due to small numbers. Therefore, five‑year aggregates are provided for point‑in‑time comparisons for jurisdictions and across age groups and remoteness areas.

All causes of death data from 2006 onward is subject to a revisions process. Once the data for a reference year is 'final', it is no longer revised. The data presented here is final for 2019 and earlier years, at the revised stage for 2020 and preliminary for 2021 and 2022. See the Data quality section of the methodology in the Causes of Death, Australia, 2022 publication available here: www.abs.gov.au/methodologies/causes-death-australia-methodology/2022#data-quality

Coronial cases are more likely to be affected by a lag in registration time, especially those which are due to external causes, including suicide. Due to small numbers these lagged coroner‑referred registrations can create large yearly variation in some causes of deaths of Aboriginal and Torres Strait Islander persons. Caution should be taken when making year to year analysis.

Caution should be taken when interpreting figures relating to intentional self‑harm and when conducting time series analysis (due to changes in Indigenous identification and causes of death coding processes over time). See Causes of Death, Australia methodology (www.abs.gov.au/methodologies/causes-death-australia-methodology).

The data for Indigenous status is influenced by the quality of Aboriginal and Torres Strait Islander identification of people in the death registration process, which is likely to differ across jurisdictions and over time. In 2022, there were 975 deaths registered in Australia for whom Indigenous status was not stated, representing 0.5% of all deaths registered.

Queensland deaths for 2010 have been adjusted to minimise the impact of a number of late registrations received in that year on mortality indicators.

Some age‑standardised rates are unreliable due to small numbers of deaths over the reference period. This can result in greater volatility of rates. Please refer to the How to interpret the data page for more information.

Comparisons of rates since 2016 should be used with caution, as the Aboriginal and Torres Strait Islander population estimates are underestimated. Please refer to the How to interpret the data page for more information.

From 2016, reference year deaths with not stated age have not been prorated.

Future reporting:

Future reporting will seek to include the following additional disaggregations:

  • all states/territories (currently only available for New South Wales, Queensland, Western Australia, South Australia and the Northern Territory)
  • disability
  • socio‑economic status of the locality.

Supporting indicators

Driver

  • Non-fatal hospitalisations for intentional self-harm
  • Intentional self-harm mortality rate (suicide)
  • Hospitalisations for mental health-related disorders

Contextual information


Material for download

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