Background – We will describe briefly the continuing gap in health and life expectancy between the Aboriginal and the broader Australian peoples. While some important advances have occurred in Indigenous health in other countries, Aboriginal people in Australia continue to experience significant inequalities in terms of life expectancy at birth, life chances, health status and life expectancy at almost any age compared to the rest of the population.
In addition, the Aboriginal population is only 2.8% of the total, which raises the question of why such a small and geographically dispersed population continues to experience such high levels of social, material and health disadvantage (1).
Objectives – To describe, via an Epidemiological Transition Model (2), some reasons behind the continuing poor morbidity and mortality and use this model to review nutrition programmes in the community context.
Discussion – Indigenous peoples are in a mid 20th century epidemiologic transition of premature disease and disability. This transition occurred for the broader Australian population some 100 or so years ago. At the same time the Indigenous population is increasing and growing younger and not ageing in the same way as we see in the rest of Australian society. These facts challenge many in policy and programme development to design appropriate interventions. Those programmes that work well seem to use a determinants of health model (3) and build on a definition of health that considers not only at the lack of physical disease, but also the wellbeing of ones family and community, physically, emotionally and spiritually.
Conclusion – Programmes and interventions must be designed with the target community and population in mind. The use of programmes developed for populations that are in the fifth epidemiologic transition, that is, for the broader Australian community, will not work for those who are still reeling from the effects of disease and disability a century old. As we have seen, those programmes that work do so because they take this into account.
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