First Nations health: birthweight targets improve while life expectancy gap remains

First Nations health: birthweight targets improve while life expectancy gap remains

The latest Closing the Gap targets: key findings and implications report from the Australian Institute of Health and Welfare (AIHW) shows that while progress has been made, the goal of closing the life expectancy gap by 2031 remains off track. But there is a positive sign in another key health target: the proportion of First Nations babies born at a healthy birthweight is improving and on track to meet the 2031 target.

The Closing the Gap framework was designed to address longstanding health disparities between Indigenous and non-Indigenous Australians. The first key health target—ensuring First Nations people live long and healthy lives—aims to close the life expectancy gap within a generation. However, the data shows that this goal is not on track.

Between 2020 and 2022, life expectancy at birth was 71.9 years for First Nations males and 80.6 years for non-Indigenous males, a gap of 8.8 years. For females, the gap was slightly smaller, with First Nations women expected to live 75.6 years compared to 83.8 years for non-Indigenous women. The data also highlights how remoteness and socioeconomic disadvantage further compound the disparity. Life expectancy was highest for First Nations people living in Inner and Outer Regional areas but dropped significantly in Remote and Very Remote regions—where First Nations males had a life expectancy of just 67.3 years.

The socioeconomic divide is equally stark. Life expectancy was lowest for First Nations people living in the most disadvantaged areas, at just 69.5 years for males and 74 years for females. Even among non-Indigenous Australians in similarly disadvantaged areas, life expectancy was still notably higher. The report estimates that if First Nations people had experienced the same age-specific mortality rates as non-Indigenous Australians between 2017 and 2021, there would have been 9,200 fewer deaths—roughly 1,006 fewer deaths per year among First Nations males and 834 fewer among females.

While the data on life expectancy paints a concerning picture, there is a positive development in the second health target: ensuring First Nations babies are born healthy and strong. The goal is to increase the proportion of First Nations babies born at a healthy birthweight to 91% by 2031, and the latest report suggests this is on track.

In 2021, 89.6% of liveborn singleton First Nations babies were born at a healthy weight, compared to 94.2% of non-Indigenous babies. This figure is above the projected trajectory point of 89.3% and approaching the national target. Encouragingly, in five out of eight states and territories, the proportion of healthy birthweight First Nations babies was at or near the 2031 goal. However, disparities persist based on geography, with birthweight outcomes lower in Remote and Very Remote areas (85–86%) compared to non-remote areas (90–91%).

Overall, the report’s findings reinforce the urgent need to address systemic healthcare inequities, particularly in access to preventive care and maternal health services. Evohealth’s Closing the medicine gap: Improving First Nations peoples’ access to medicine report has highlighted persistent barriers to accessing prescription medicines, an issue that directly affects both chronic disease management and maternal health outcomes. Expanding access to culturally safe healthcare, increasing support for maternal health programs, and ensuring equitable distribution of essential medicines will be critical to sustaining progress in birth outcomes and accelerating improvements in life expectancy.

As the latest data shows, the challenge of achieving health equality for First Nations Australians remains significant. But progress is being made, and with continued targeted investment and evidence-based policies, meaningful progress is possible.