When a risk factor for poor health affects one part of a community more than another, policymakers have two choices: continue with a one-size-fits-all approach or find a new way to focus on the population most at risk.
“The burden of disease and injury in Australia 2003,” a report released in 2007, showed that tobacco use was the leading risk factor for disease burden in the country.
The study also revealed stark differences in the health outcomes of indigenous Australians compared to Australians overall. A companion article to the 2007 report pointed to the large disparity between these two groups, known as the “indigenous health gap,” with tobacco use as the primary risk factor; in fact, tobacco-related conditions accounted for 17% of the gap. Also, a national survey conducted between 2008 and 2009 determined that nearly 48% of Australian Aboriginals and Torres Strait Islander males and females aged 18 and older smoked regularly, in contrast to around 19% of the non-Aboriginal population, according to Australia’s 2007-2008 National Health Survey.
Secretary of the Department of Health Jane Halton took action. By March 2008, the Australian government had pledged AU$14.5 million to launch the Indigenous Tobacco Control Initiative, which aims to halve smoking rates in indigenous communities by 2018.
How effective has this initiative been? The data collected in a new Australian Global Burden of Disease study that will estimate early death and disability at the local level among all Australians and separately measure health disparities in Aboriginal and Torres Strait Islander people will help shed light on this question. Professor Halton announced AU$5 million in funding for this study in May 2013. “Australia is attempting to close the indigenous health gap through interventions such as training health workers to help smokers quit, requiring plain packaging of cigarettes, and disseminating anti-smoking ads,” said Professor Theo Vos, a Global Burden of Disease researcher and co-author of past Australian burden of disease studies. “Surveys measuring smoking prevalence and this study will serve as progress reports for policymakers and will allow them to adjust their strategies as needed.”