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and important correlates of criminal offending and high frequency substance abuseamong 371 juvenile offenders.A study by Loxley, Toumbourou and Stockwell (2004) found that:• Social disadvantage particularly as reflected in factors such as unemployment,homelessness or insecure housing and poverty — is clearly linked to healthdamagingbehaviours, including the misuse of alcohol and other drugs. (p.14)• Drug use, both licit and illicit, is associated with high health, legal and social coststo communities and families, as well as to users. It is associated with crime andviolence, sexual assault and domestic violence. Crime is strongly associated withalcohol and drug use, particularly alcohol with violence and heroin with propertycrime. Drug use has impacts on families, the workforce and road trauma; and itaffects public safety and amenity, not only through perceived threat, but throughdisturbances such as noise, litter and public intoxication. (p.3)The relative socioeconomic disadvantage experienced by Indigenous Australianscompared with other Australians may place them at greater risk of ill health, whichin turn can exacerbate their already disadvantaged socioeconomic positions.Indigenous people generally experience high levels of harm as a result of alcohol,tobacco and other drug use. According to AIHW (2006), which provided datacollected from 635 alcohol and other drug treatment agencies across Australia,Indigenous people accounted for almost 10 per cent of total clients who soughttreatment for drug and alcohol use in 2004-05. 1 This was almost five times theproportion of Indigenous people in the Australia population 2 , Compared with non-Indigenous clients, Indigenous clients were more likely to be in the youngest group(10–19 years), and more likely to nominate alcohol as the principle reason forseeking treatment.A study by Ridolfo and Stevenson (2001) estimated that in 1998 the use of tobacco,alcohol and other (illicit) drugs caused about 25 per cent (7 000) of the deaths ofAustralians under 65 years old, among which over 2 000 deaths were related toalcohol (which include alcohol related road injuries), about 4 200 related tosmoking and 1 000 related to illicit drug use. However, there is no informationavailable regarding Indigenous status in this study.1 The proportion may be even higher because of the relatively high proportion of treatment periodswhere Indigenous status was ‘not stated’ (5 per cent) and because the majority of dedicatedsubstance use services for Aboriginal and Torres Strait Islander people were not included in thecollection.2 These data are not age standardised and consequently do not take into account the largerproportion of younger people in the Indigenous population and the effect this might have on ratesof people seeking drug and alcohol treatment.8.2 OVERCOMINGINDIGENOUSDISADVANTAGE 2007
This chapter examines patterns in, and harms related to, the use and misuse ofalcohol, tobacco and other drugs among Indigenous and non-Indigenous people.Following feedback and comments from consultation on the 2005 Report, thischapter has been restructured. In the 2003 and 2005 Reports patterns in alcohol andtobacco consumption were reported in one section, and alcohol and tobacco relatedharms in another. This chapter now reports three indicators by type of substance,covering patterns in use and related harms for each type of substance. The threeindicators are:• 8.1 Alcohol consumption and harm• 8.2 Tobacco consumption and harm• 8.3 Drug and other substance use and harm.New data on hospitalisations related to tobacco use and drug influenced homicidesare included for the first time in this Report.Attachment tablesAttachment tables for this chapter are identified in references throughout thischapter by an ‘A’ suffix (for example, table 8A.1.1). A list of attachment tables is insection 8.5. These tables can be found on the Review web page(www.pc.gov.au/gsp). Users can also contact the Secretariat to obtain theattachment tables.SUBSTANCE USE ANDMISUSE8.3
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© Commonwealth of Australia 2007IS
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ForewordIn 2003, when heads of Aust
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ContentsForewordContentsAcronyms an
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7.4 Juvenile diversions as a propor
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Acronyms and abbreviationsABSACDPAC
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LSAYLSICMCATSIAMCEETYAMOUNATSISNATS
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GlossaryAboriginalAge standardisedr
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ICDEquivalisedhousehold incomeIncom
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For example, the gross monthly inco
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StatisticalsignificanceStatistical
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In May 1997, I wrote to your predec
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situations of Aboriginal people and
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Other health outcomes deteriorated.
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• Indigenous owned or controlled
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Governments and Indigenous people h
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• on-going government support (in
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Source: ABS (2004b); table 3A.1.1.D
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Apparent retention rates of full ti
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The labour force participation rate
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Home ownership is an important econ
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Substantiated child abuse and negle
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Box 1.16KEY MESSAGES• Comparable
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Age standardised adult imprisonment
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Strategic areas for actionFunctiona
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Box 1.21Things that work• The Jab
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Box 1.25Things that work• Congres
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Box 1.28KEY MESSAGES• Data on too
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elationship between the number of d
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uilt upon, or interventions can ass
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Box 1.37KEY MESSAGES• In 2006, 8
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Box 1.41Things that work• The Cir
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Alcohol consumption at long term ri
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Box 1.47• In 2004-05:KEY MESSAGES
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Prisoners, by known prior adult imp
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Box 1.54Things that work• The Mar
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ceremonies, rituals and history. So
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Communication with service provider
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Hospitalisation rates for Indigenou
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Indigenous people 15 years and over
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Box 1.67Things that work• The Abo
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mining royalties and tourism), Indi
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Box 1.74KEY MESSAGES• Six determi
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Median (mid point) individual incom
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FUTURE DIRECTIONS IN DATANotwithsta
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1 IntroductionIn April 2002, the Co
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In order to provide a comprehensive
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Identify indicators that are of rel
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—— 2004-2007a, Report on Govern
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2 The frameworkThe first two sectio
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3. Strategic areas for actionGovern
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Headline indicatorsThe headline ind
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Figure 2.2.3 A preventive model —
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• Retention at year 9• Indigeno
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Similarly, the previous indicator
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In 2006, following publication of t
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Suggested cultural indicators were
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The ‘Economic participation and d
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• Survey data: surveys, such as t
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• 2004-05 National Health Survey
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—— 2004b, National Aboriginal a
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3 Headline indicatorsSafe, healthy
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specific death rates 1 ) continued
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while the life expectancy of Indige
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Table 3.1.2Age specific death rates
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• In the period 2001 to 2005, age
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Box 3.2.2‘Things that work’ - d
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In 2002, the proportion of Indigeno
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• Among older people (aged 55 yea
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people with at least one long-term
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Table 3.2.1Age standardised hospita
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wellbeing (and other positive healt
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Health and education are intimately
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Figure 3.3.2 Apparent retention rat
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Figure 3.3.4 Apparent retention rat
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• Nationally, the proportion of I
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• their health outcomes and their
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extent to which people over 18 year
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Post secondary attainmentOne measur
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• In 2005, the national load pass
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3.5 Labour force participation and
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communities where the labour market
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Figure 3.5.2 CDEP participation, In
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Table 3.5.1Labour force participati
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• Nationally, the labour force pa
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Figure 3.5.7 Unemployment rate of p
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Figure 3.5.9 Unemployment rate of p
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Figure 3.5.10 Long term unemploymen
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Chapter 12 of this Report discusses
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Box 3.6.2(continued)Median value is
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Figure 3.6.1 Median gross weekly eq
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the population into five equal grou
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Figure 3.6.5 Distribution of gross
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• Age-related patterns in income
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Box 3.7.2‘Things that work’ —
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easonably simple to derive and prov
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Figure 3.7.2 Proportion of Indigeno
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3.8 Suicide and self-harmBox 3.8.1K
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Box 3.8.2(continued)A study found t
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Figure 3.8.2 Intentional self-harm
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Figure 3.8.3 Average annual suicide
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• Analysis of data from the Top E
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healthy and supported by their fami
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Figure 3.9.1 Rate per 1000 children
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Figure 3.9.3 Children aged 0-16 yea
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Table 3.9.1Number of diagnoses of c
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Indigenous than non-Indigenous peop
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Figure 3.10.1 Homicide death rates,
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Figure 3.10.3 Average annual homici
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Table 3.10.1 Comparative statistics
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Patterns and trendsPatterns and tre
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Hospitalisations for assaultFigure
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The lack of a common definition mea
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Box 3.11.2 (continued)A key compone
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• Indigenous women reported highe
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Figure 3.11.2 SAAP support periods:
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New South WalesFigure 3.11.3 Victim
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VictoriaFigure 3.11.5 Victims recor
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non-Indigenous people (65.3 per cen
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Figure 3.11.7 Victim-offender relat
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Northern TerritoryTable 3.11.2 Vict
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murder the offender was ‘other’
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Box 3.12.2 (continued)Victoria’s
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People under 18 years are treated a
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Figure 3.12.1 Age standardised impr
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past five years, the rates of impri
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Juvenile detentionFigure 3.12.4 Juv
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• Nationally on 30 June 2005, the
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3.11 Family and community violenceT
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Table 3A.3.10Table 3A.3.11Table 3A.
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3.6 Household and individual income
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3.11 Family and community violenceT
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Table 3A.11.46Table 3A.11.47Table 3
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—— and AIHW (Australian Institu
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http://www.who.int/hpr/NPH/docs/ott
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Hunter, B. and Gray, M. 1999, Furth
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Swan, P. and Raphael, B. 1995, Ways
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—— 2005, Through Young Black Ey
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—— 2006, Population by Age and
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3.12 Imprisonment and juvenile dete
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4 Strategic areas for action4.1 The
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5 Early child development and growt
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cited in Couzos, Metcalf and Murray
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some Aboriginal communities are ass
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Box 5.1.2(continued)Growth Assessme
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preventable condition for which Ind
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Figure 5.1.2 Deaths from external c
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Box 5.2.2(continued)Between 1993-95
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Figure 5.2.2 Infant mortality, by I
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irth weight are compounded by high
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Box 5.3.2(continued)Strong Women, S
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Box 5.3.2(continued)The model was d
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abies had non-Indigenous mothers an
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5.4 Hearing impedimentsBox 5.4.1Key
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Box 5.4.2(continued)• Chronic oti
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Figure 5.4.2 Prevalence of otitis m
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• Although the hospitalisation ra
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Table 5.5.1Children’s mean number
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• The percentage of Indigenous ch
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difference in scores between Indige
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• According to the 2002 Child Den
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• A greater proportion of Indigen
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Figure 5.5.5 Hospital dental proced
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The proposed Longitudinal Study of
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5.8 References5 Early child develop
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Central Public Health Unit Network
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Mackerras D 1998, Evaluation of the
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Leach, A.J., Boswell, J.B., Asche,
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Harford, J., Spencer, J., Roberts-T
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6 Early school engagement andperfor
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2002). Gaps that appear in children
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Table 6.1.1Participation rates in p
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this approach was legal (DEWR 2006)
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• School participation rates are
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Box 6.3.2(continued)Scaffolding Lit
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Figure 6.3.2 Proportion of year 3 s
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6.3 Year 3 literacy and numeracyTab
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NTDE (Northern Territory Department
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Young People, Curtin University of
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7 Positive childhood and transition
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In most states and territories, com
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Attachment tablesAttachment tables
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Nationally comparable learning outc
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Year 5 writingFigure 7.1.3 Proporti
Page 379 and 380: Year 5 numeracyFigure 7.1.5 Proport
Page 381 and 382: Year 7 readingFigure 7.1.7 Proporti
Page 383 and 384: Year 7 writingFigure 7.1.9 Proporti
Page 385 and 386: Year 7 numeracyFigure 7.1.11 Propor
Page 387 and 388: then year 7 in 2005, and be tested
Page 389 and 390: Figure 7.1.15 Proportion of year 3
Page 391 and 392: non-Indigenous children, reducing t
Page 393 and 394: 7.3 Indigenous cultural studies in
Page 395 and 396: Box 7.3.2Bendigo Senior Secondary C
Page 397 and 398: Box 7.3.6Western Arrernte Picture D
Page 399 and 400: Table 7.3.1 Indigenous employment i
Page 401 and 402: Box 7.3.8RATEP — a community base
Page 403 and 404: Box 7.4.2(continued)• Police and
Page 405 and 406: New South WalesTable 7.4.1NSW, numb
Page 407 and 408: pattern was observed for non-Indige
Page 409 and 410: Figure 7.4.2 WA, Indigenous and non
Page 411 and 412: Figure 7.4.3 SA, proportion of Indi
Page 413 and 414: 7.5 Transition from school to workB
Page 415 and 416: (see section 7.2 Retention at year
Page 417 and 418: studying, for both Indigenous and n
Page 419 and 420: • Similar patterns to those in th
Page 421 and 422: 7.6 Future directions in dataYears
Page 423 and 424: Table 7A.4.12Table 7A.4.13Victoria,
Page 425 and 426: Paper National Benchmark Results Re
Page 427: Randell, N. (ed.) 2002, Including t
Page 432 and 433: 8.1 Alcohol consumption and harmBox
Page 434 and 435: Patterns of alcohol consumptionThe
Page 436 and 437: Figure 8.1.1 Alcohol consumption at
Page 438 and 439: • For both Indigenous and non-Ind
Page 440 and 441: Table 8.1.3Alcohol consumption at s
Page 442 and 443: Figure 8.1.4 Alcohol involvement in
Page 444 and 445: disability and behaviour problems (
Page 446 and 447: • hospitalisation rates for all c
Page 448 and 449: Data on tobacco use in this section
Page 450 and 451: current daily smokers than non-Indi
Page 452 and 453: Figure 8.2.4 Mothers reporting smok
Page 454 and 455: 8.3 Drug and other substance use an
Page 456 and 457: In 2004-05, among Indigenous adults
Page 458 and 459: interventions, there had been a red
Page 460 and 461: Drug related crimeBroadly speaking,
Page 462 and 463: Figure 8.3.2 Drug influenced Indige
Page 464 and 465: • develop an appropriate methodol
Page 466 and 467: Strait Islander Peoples 2005, ABS C
Page 468 and 469: AIHW (Australian Institute of Healt
Page 470 and 471: Makkai T. and Payne J. 2003, Drugs
Page 472 and 473: • income• suicide and self-harm
Page 474 and 475: Following consultations in 2006, a
Page 476 and 477: Attachment tablesAttachment tables
Page 478 and 479: An increased rate may also be due t
Page 480 and 481:
Figure 9.1.1 Placement of Indigenou
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Box 9.2.2(continued)their local com
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Adult repeat offendingFigure 9.2.1
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• Nationally in 2006, 75.3 per ce
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69.0 per cent had been in prison pr
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juvenile justice system and 2 496 a
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juvenile justice system was dismiss
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chronic disease, early child develo
Page 496 and 497:
Page 498 and 499:
Table 9.3.1Expenditure on health ca
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Table 9.3.2Age standardised hospita
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presents hospitalisation rates for
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lower than those in 2001-02 for bot
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Figure 9.3.2 compares the length of
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non-remote areas were twice as like
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• A greater proportion of discret
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The following definitions of mental
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Box 9.4.2(continued)Aboriginal Ment
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• In 2004-05, 48.0 per cent of In
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• Life events or ‘stressors’
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• Over the period, the age-standa
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Table 9.4.2Indigenous standardised
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Death rates for mental and behaviou
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A WA study on prisoner health and m
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• The proportion of children at h
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Some Indigenous people living in ci
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Figure 9.5.3 Proportion of Indigeno
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were judged by their teachers to be
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Figure 9.6.2 Participation in exerc
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Box 9.6.3Little Yuin Aboriginal Pre
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Box 9.6.6Athletics Australia ‘Ath
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Box 9.6.8(continued)The Australian
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discrete Aboriginal and Torres Stra
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Figure 9.7.3 How Indigenous people
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Figure 9.7.5 Communication with ser
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Indigenous communities. 2 The 2006
Page 552 and 553:
with the 1993 Western Australian Ch
Page 554 and 555:
Box 9.7.3Health Education Unit —
Page 556 and 557:
Box 9.7.5Interpreter accreditation
Page 558 and 559:
Box 9.7.8Pre-hospital care in remot
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Participation in organised sport, a
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9.3 Access to primary health careTa
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age standardised, by remoteness are
Page 566 and 567:
Page 568 and 569:
SHRG (Social Health Reference Group
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9.4 Mental healthABS (Australian Bu
Page 572 and 573:
Procter, N. 2005, ‘Parasuicide, s
Page 574 and 575:
Daly, A.E. 2001, Implications of De
Page 576 and 577:
Menzies School of Health Research 2
Page 578 and 579:
infrastructure as well as functioni
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some duplication, as patients can h
Page 582 and 583:
After adjusting for age differences
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Figure 10.1.2 Age standardised hosp
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Figure 10.1.3 Hospitalisation rates
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Figure 10.1.4 Death rates from dise
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In rural and remote areas, there is
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In June 2006, an estimated 510 000
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Figure 10.2.2 Experienced water int
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Types of sewerage systemsIn the 200
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Access to cooking, washing and toil
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The occupancy standard determines o
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• There were no statistically sig
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Figure 10.3.4 Proportion of Indigen
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10.2 Access to clean water and func
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Pholeros P., Rainow S. and Torzillo
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Indigenous owned land yields econom
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Box 11.1.2 ‘Things that work’
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Box 11.1.2 (continued)The success o
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Employment by full time/part time s
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Figure 11.1.3 Full time and part ti
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Figure 11.1.5 Full time and part ti
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Data on full time and part time emp
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• CDEP participation accounted fo
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people’s wellbeing (see section 1
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Box 11.2.2 Walking Tourism Business
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11.3 Indigenous owned or controlled
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The potential to derive economic be
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• land-based investments for capi
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Box 11.3.2 (continued)In 2006, fund
Page 638 and 639:
Indigenous Land Use AgreementsIndig
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• Indigenous owned or controlled
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Figure 11.3.4 The growth of Indigen
Page 644 and 645:
and corporate behaviour, and descri
Page 646 and 647:
Box 11.4.2 ‘Things that work’
Page 648 and 649:
Figure 11.4.1 Proportion of univers
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while the proportion of non-Indigen
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State and Territory data on the num
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areas of agreement, ‘governments
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Indigenous organisations, by and la
Page 658 and 659:
• Coordination and decision makin
Page 660 and 661:
Box 11.5.4 (continued)The Board of
Page 662 and 663:
Box 11.5.6 (continued)3. Are effect
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Box 11.5.8 (continued)The Pitjantja
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Box 11.5.10 Governance trainingWuna
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• strategic policy and evaluation
Page 670 and 671:
Box 11.5.13 Developing youth leader
Page 672 and 673:
third parties enter into an equal a
Page 674 and 675:
The OIPC red tape evaluation (OIPC
Page 676 and 677:
old. Some will be new’ (Cornell a
Page 678 and 679:
circumstances or risk profile of th
Page 680 and 681:
11.6 Future directions in dataEmplo
Page 682 and 683:
Table 11A.1.10 Occupation skill lev
Page 684 and 685:
11.3 Indigenous owned or controlled
Page 686 and 687:
Gerritson, R. 2001, Community Capac
Page 688 and 689:
Reconciliation Australia 2006b, 200
Page 690 and 691:
Torres Strait Islander people compr
Page 692 and 693:
Labour force participation and unem
Page 694 and 695:
section 12.1). The files containing
Page 696 and 697:
Attachment tablesAttachment tables
Page 698 and 699:
Patterns of relative disadvantage b
Page 700 and 701:
13.1.2 Differences between women an
Page 702 and 703:
Figure 13.1.3 Relative disadvantage
Page 704 and 705:
13.2 Associations between headline
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Figure 13.2.2 People aged 15 years
Page 708 and 709:
Figure 13.2.4 People aged 15 years
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Box 13.3.1 (continued)For example,
Page 712 and 713:
• more common among unemployed pe
Page 714 and 715:
13.4 Notes on methodologyThe analys
Page 716 and 717:
13.22 OVERCOMINGINDIGENOUSDISADVANT
Page 718 and 719:
• reviewing and re-engineering pr
Page 720 and 721:
The working group will consider how
Page 722 and 723:
Australian Government commentsThe f
Page 724 and 725:
New South Wales Government comments
Page 726 and 727:
Victorian Government commentsIn Oct
Page 728 and 729:
Queensland Government commentsThe Q
Page 730 and 731:
Western Australian Government comme
Page 732 and 733:
South Australian Government comment
Page 734 and 735:
Tasmanian Government commentsThe Ta
Page 736 and 737:
Australian Capital Territory Govern
Page 738 and 739:
Northern Territory Government comme
Page 740 and 741:
IMPLEMENTATION OFTHE FRAMEWORKA2.21
Page 742 and 743:
Figure A3.2 Proportion of the popul
Page 744 and 745:
• The proportion of the Indigenou
Page 746 and 747:
e disaggregated by different factor
Page 748 and 749:
identify when asked by police. Henc
Page 750 and 751:
Indicators Measures Data sources3 H
Page 752 and 753:
Indicator Measure Data source3.5 La
Page 754 and 755:
Indicator Measure Data source3.10 D
Page 756 and 757:
Indicator Measure Data source5.5 Ch
Page 758 and 759:
Indicator Measure Data source7.5 Tr
Page 760 and 761:
Indicator Measure Data source9.2 Re
Page 762 and 763:
Indicator Measure Data source9.5 Pr
Page 764 and 765:
Indicator Measure Data source11 Eco
Page 766 and 767:
Acronyms and abbreviationsABSACERAI
Page 768:
Australia 1995-2003, Trends and Iss
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