Why constitutional recognition of Aboriginal and Torres Strait Islander peoples matters for health

Aboriginal and Torres Strait Islander Australians alive today can expect to live shorter lives, and to carry a higher burden of illness, compared with other Australians. The ill health of Australia’s First Peoples is the result of historic social exclusion and economic disadvantage.

Aboriginal and Torres Strait Islander people are legally excluded in the Australian Constitution—the nation’s founding legal document that came into effect in 1901—in that their prior existence and survival on this land for tens of thousands of years is not acknowledged.

As we know for anyone living in poverty, with poor housing, lower income and less education, that health will suffer; this is also true for Aboriginal and Torres Strait Islander people. But Aboriginal and Torres Strait Islander people also experience social exclusion, racism and discrimination and historical, inter-generational effects of the loss of land, culture and language (for example, those affected by the past government policies and practices, ie the Stolen Generations). These factors are known as ‘the social and cultural determinants of health’.

There is significant evidence from health research to indicate that being connected to the wider community, having a strong identity and feeling socially supported, all have powerful impacts on health.

Constitutional recognition would be a huge step forward for addressing the health inequity between Indigenous and non-Indigenous Australians. Recognition of the distinct identities and cultures of Indigenous Australia is vitally important for the health and wellbeing of Aboriginal and Torres Strait Islander people. Moreover, it is important for the collective pride of all Australians.

In countries like Australia, many of us benefit from having excellent conditions for health. Obtaining an education, making a meaningful contribution by having a job and an income, having peace and safety in our streets and homes and having a sense of belonging to our immediate and wider community—all contribute to a sense of wellbeing.

It is difficult for those who enjoy the right conditions for health and who have not experienced social exclusion and relative poverty to understand how it affects people’s health. But the research tells us that it does. It is perhaps easier to understand that if Australia’s First Peoples enjoyed greater educational outcomes, employment opportunities, freedom from racism and discrimination and better housing conditions, chances for a long and healthy life would be very different.

While there is much to be done, recognition in the Constitution would put everyone’s efforts on a stronger footing especially the efforts of Aboriginal and Torres Strait Islander people to achieve their own vision for healthy lives. Constitutional recognition is a vital step towards making Aboriginal and Torres Strait Islander people feel historically and integrally part of the Australian nation, and for the nation to connect with its past.

Recognition would also enable the health care system to develop better policy and practice to meet the health care and cultural needs of Aboriginal and Torres Strait Islander people. It would provide the basis for a better social contract—where both Aboriginal and non-Aboriginal people know they stand on solid and equal ground and can work out shared solutions to both common and unique problems.

The health organisations that have signed the Health Coalition Statement represent a wide range of health professions and consumers, and collectively they have expertise in the major physical and mental health conditions that inequitably affect Aboriginal and Torres Strait Islander people. These organisations are united in their conviction that recognition in the Constitution will provide the basis for an important shift in policy, health care practice and in the community’s acceptance of Aboriginal and Torres Strait Islander people’s contribution to our national life. It will enable us to go beyond our discomfort about our shared history and move towards a situation that most Australians would welcome, that is, a country that can be proud of being home to the oldest living cultures in the world, and where Aboriginal and Torres Strait Islander people have an equal chance for a long, healthy and productive life. This would be good for all Australians.

Acknowledgement of Aboriginal and Torres Strait Islander peoples’ prior existence as the oldest living culture on earth, and as the First Peoples of Australia, can provide a powerful sense of identity, pride and belonging, and can assist people to improve their chances for full participation in all Australia has to offer—all of which will have positive consequences for health and wellbeing.

Recognition of Aboriginal and Torres Strait Islander people in the Constitution will right a historic wrong, and establish a sound basis for further progress towards health and healing both for Aboriginal and Torres Strait Islander Australians, and for the nation as a whole.