The ongoing crisis in Indigenous health is due to generations of neglect, lack of cohesive public policy and failure to provide sufficient resources and ensure that they reach people on the ground.

The underlying causes of poor Indigenous health can be attributed to social and economic exclusion, unemployment, low income, poor housing and sanitation, poor education, and lack of adequate nutrition. Despite suffering from much worse health than other Australians, indigenous people generally have much less access to health care services.

Historically, Indigenous people have had little power to influence these factors and the public policy decisions that affect their lives and health.

A history of neglect

The poor state of Indigenous health today needs to be seen in the historic context of broader attitudes and policies about Aboriginal and Torres Strait Islander people enacted by state and territory governments.

The Commonwealth has only had the power to act in Indigenous affairs since 1967, and only recently has it generally been accepted that Indigenous people should have control over their own lives and enjoy the same rights as other Australians.

Protection for whom ? (1837-1937)

Almost from the beginning of colonisation, Aboriginal populations were devastated by introduced diseases and the loss of land and livelihood. Despite the high loss of life and widespread ill health, little was done to provide medical aid. It was not until 1837 that a policy of “protection” was enacted, after decades of frontier violence.

Under the protection policies which remained in place throughout the next century, “protectors were appointed, reserves were established and Aboriginal populations were segregated on missions and government settlements, in part to prevent the spread of contagious diseases to non-Aboriginal people.

Throughout this era, the prevailing attitude was that Aboriginal peoples were inferior to white races and would inevitably die out. In the late 19th and early 20th centuries, legislation to further separate mixed race people and empower “protectors” to remove children from their families was progressively passed in the states and the Northern Territory. In some states, mixed race people were forced to leave the reserves.

Assimilation into non-Indigenous Australia (1937-1960s)

In 1937, protection gave way to an official policy of “assimilation”, especially of mixed race Aboriginal people.

In effect, Indigenous people were expected to become like, and live like non-Indigenous Australians. Yet discriminatory policies still controlled many (sometimes all) aspects of Indigenous peoples lives, denied them equal wages and employment conditions and the social welfare benefits available to other Australians.

As late as 1953, the Commonwealth Government enacted the Wards Employment Ordinance in the Northern Territory, which made Aboriginal people wards of the state, with minor status, and discriminated against them in employment and pay. In many states, Aboriginal people were not only paid less- their wages were withheld from them and placed in trust funds that were appropriated by governments for other purposes.

The assimilation policy persisted well into the 1960s and was confirmed at a national Native Welfare Conference in 1961.

In 1965, assimilation was defined as “all persons of Aboriginal descent will choose to attain a similar manner and standard of living to that of other Australians and to live as members of a single Australian community, enjoying the same rights and privileges, accepting the same responsibilities, observing the same customs, and influenced by the same beliefs, hopes and loyalties as other Australians.”

State and territory governments began to dismantle discriminatory legislation, but in New South Wales, for example, it was not until 1969 that new legislation was introduced to replace the Aborigines Protection Act 1909.

Recognition of rights

The 1960 is generally seen as the period in which Indigenous Australians were recognised as Australian citizens. In 1962, the electoral act was amended to extend the right to vote to all Aboriginal people.

It was a decade of major social change. Indigenous people had long protested against discriminatory treatment, and non-Indigenous Australians became more aware of the true situation : Charles Perkins led the Freedom Rides in north-western New South Wales ; trade unions supported equal award wages for Aboriginal pastoral workers; the Yolgnu people of Arnhem Land (Northern Territory) protested mining on their land and lodged the famous “Bark Petition”.

A 10 year campaign culminated in the 1967 referendum. Whereas before only the states had the power to enact laws about Aboriginal and Torres Strait Islander people, a resounding 90% Yes vote finally empowered the Commonwealth to do so. For the first time, Indigenous people were also to be counted in the national census.

In the late 1960s, state and territory governments at last began to introduce special Aboriginal health programs and to train Aboriginal health workers. Research began to document the extremely poor standard of Indigenous health, and linked this to environmental and socio-economic factors.

Pressure from Aboriginal people, international scrutiny of the conditions of Aborigines and increased awareness in the wider community, began to lead to important changes in Indigenous health.

Indigenous people begin to take control (1970)

In the late 1970s, Aboriginal people began to found their own organisations, such as land councils, legal services and health services. Many were initially funded by private donations, church groups and even international aid organisations.

Since the 1970’s, many Indigenous communities have established their own independent, community-controlled health services (ACCHs) and an over-arching representatives advocacy body, the National Aboriginal Controlled Community Health Organisation (NACCHO previously NAIHO) was formed in 1975.

In 1972, the newly-elected Whitlam Government began to give tied grants to states for Aboriginal health initiatives and funding for emerging Aboriginal community-controlled health services.

A summary of events in that period

1789 Smallpox decimates Aboriginal populations of Sydney coastal regions and spreads
1835-36 New colonies at Port Phillip Bay and South Australia severely impact on local Aboriginal populations
1837 Protection policy enacted NSW
1849 Flinders Island protectorate, Bass Strait, abandoned as most Aborigines had died
1869 Victorian Board for the Protection of Aborigines established
1880 Protection introduced in South Australia
1881 NSW Protector of Aborigines appointed, separate schools established for excluded Aboriginal children
1883 NSW Aborigines Protection Board and Aboriginal reserves established
1886 Western Australian Aborigines Protection Act
1897 Queensland Aboriginals Protection and Restriction of Sale of Opium Act
1901 Federation of AustraliaThe Australian Constitution specifically prevents the new Commonwealth Government from passing laws relating to Aboriginal peoples. Aboriginal Asian and African peoples denied the right to vote
1905 Western Australian Aborigines Act establishes reserves and local protectors. Chief Protector becomes legal guardian of all Aboriginal people under 16
1909 Defence Act 1909 prohibits persons not of substantially European origin from serving in armed forces
1911 South Australian protection legislation Northern territory Aboriginals Ordinance makes Chief Protector legal guardian of all Aboriginal people under 18
1915 Despite the provisions of the Defence Act, Aboriginal people serve at Gallipoli and other fronts, World War 1NSW Aborigines Protection Board empowered to remove and apprentice Aboriginal children without a court hearingSimilar policies allowing the removal of Aboriginal children implemented in other states; practice continues up to the 1970’s
1925 Australian AboriginesProgressive Association formed to oppose NSW Aborigines Protection Board
1937 Commonwealth and State conference on native welfare adopts assimilation as the national policy
1938 26 January, Day of Mourning and Protest
1940 NSW Aborigines Protection Board replaced by Welfare Board, Aboriginal Education transferred to Department for Education which begins to provide trained teachers
1940s Aboriginal people serve in World War IIMost Commonwealth social security benefits extended to Aborigines who meet strict eligibility criteria. Many begin to leave reserves to seek employment and better living conditions.
1943 Exemption certificate excepts some Aboriginal people from restrictive legislation and allows them to vote
1946-49 Strike by Aboriginal pastoral workers in the Pilbara, Western Australia
1948 Universal Declaration of Human Rights
1951 Australian Conference for Native Welfare officially adopts policy of ‘assimilation’
1953 Commonwealth legislation makes Aboriginal people in NT wards of the state with ‘minor’ status and discriminatory employment and pay
1957 National Aboriginal and Islander Day of Observance Committee (NAIDOC) formed
1958 Federal Council for the Advancement of Aborigines established
1961 Conference of Native Welfare Ministers confirms assimilation policy
1962 Commonwealth Electoral Act amended to give all Aboriginal people the right to vote
1963 Yirrkala Bark petition
1965 Freedom Ride in New South Wales
1966 Australia signs International Convention of the Elimination of all forms of Racial DiscriminationGuringji ‘walk off’ from Wave Hill Station, Northern TerritoryAward wages granted to Aboriginal pastoral workers
1967 Constitutional Referendum on Aboriginal Rights empowers Commonwealth to pass legislation relating to Aboriginal and Torres Strait Islander people and count them in census
1971 Aboriginal Tent Embassy Erected in Canberra
1972 Whitlam Government elected 1972 census first to include Indigenous people
1973 First national ‘Ten Year Plan for Aboriginal Health’
1975 National Aboriginal and Islander Health Organisation (NAIHO) formed
1979 House of Representatives Standing Committee on Aboriginal Affairs ReportAboriginal Health, States that poor Aboriginal Health is due to low standards of environmental and housing conditions, socio-economic factors and inappropriate health services
1987 Royal Commission into Aboriginal Deaths in Custody establishedNational Aboriginal Health Strategy Working Party established